3D Breast Tomosynthesis Better at Detecting Cancer than 2D Mammography

Mammography screening with 3D digital breast tomosynthesis (DBT) yields lower recall rates and increased cancer detection, compared with 2D digital mammography (DM), according to a study published in the American Journal of Roentgenology.

Researchers from Fairfax, Va., Bethesda, Md. and Israel assessed the clinical performance of combined 2D-3D DBT compared with 2D DM alone for screening mammography in a community-based radiology practice. The study period ran from August 2011 to November 2012. Fourteen radiologists compared the screening mammographies - 23,149 patients with 3D DBT versus 54,684 patients with 2D DM.

The results showed better results with 3D DBT over 2D DM:

• 3D DBT had a 16.1 percent lower recall rate than did 2D DM

• Overall cancer detection rate was 28.5 percent greater for 3D DBT (6.3 per 1,000 compared with 4.9 per 1,000 for 2D DM)

• Invasive cancer detection was 43.8 percent higher for 3D DBT (4.6 per 1,000 compared with 3.2 per 1,000 with 2D DM)

• Positive predictive value for recalls from screening was 53.3 percent greater for 3D DBT (4.6 percent) compared with 2D DM (3.0 percent)

• There was no significant difference in the positive predictive value for biopsy for 3D DBT versus 2D DM (22.8 percent and 23.8 percent, respectively)

“We observed a significant increase in the detection rate for cancer overall and an even greater increase in the detection rate for invasive cancer,” coauthor Julianne Greenberg said in a release. “Our results may be a bellwether for the impact of tomosynthesis on population-based breast cancer screening.”