Assessment of Breast Density Comparable Between Digital Mammography and Digital Breast Tomography

New BCSC study finds that radiologists’ assessment of breast density does not differ between Digital Mammography and Digital Breast Tomography, which has implications for breast cancer risk assessment with these modalities.

Posted by Jeff Tice at 3:00 PM on Dec 17, 2021


A new BCSC study addressed the question of whether the shift from women undergoing digital mammography (2D) to digital breast tomography (3D) impacts radiologists’ assessment of breast density and whether this would further impact assessing a woman’s future breast cancer risk. The study evaluated 403,326 pairs of mammograms from 342,149 women who had two mammograms no more than 36 months apart. There were no significant differences in breast density assessment in pairs consisting of one 2D mammogram and one 3D (77.0% agreement), both 2D mammograms (79.1% agreement), and both 3D mammograms (77.3% agreement). Results were similar in sensitivity analyses limited to pairs read by the same radiologist, less than 18 months apart, or read after the change in BI-RADS lexicon in 2014. Breast cancer associations with breast density categories were similar for 2D and 3D mammography.  The authors concluded radiologists' reporting of BI-RADS density using 3D mammograms did not differ from that reported for 2D mammogram. Thus, the implications of breast density for breast cancer risk assessment is the same for both modalities.

Tice JA, Gard CC, Miglioretti DL, Sprague BL, Tosteson ANA, Joe BN, Ho TH, Kerlikowske K. Comparing Mammographic Density Assessed by Digital Breast Tomosynthesis or Digital Mammography: The Breast Cancer Surveillance Consortium. Radiology. 2021 Nov 23:204579. Epub ahead of print. PMID: 34812671. https://pubs.rsna.org/doi/10.1148/radiol.2021204579 [Link to article]

Posted by: Jeff Tice