Tomosynthesis Plus Mammography Screening and Cancer Detection, Recall Rates

Adding tomosynthesis to digital screening mammography increases cancer detection rates while decreasing recall rates, according to a study published in Breast Cancer Research and Treatment.

Researchers from several states in the U.S. sought to determine the effect of tomosynthesis imaging as a function of age for breast cancer screening. To do this, the researchers examined and compared screening performance metrics from 13 institutions for 12 months prior to introduction of tomosynthesis with those performed after introduction of tomosynthesis. The time ranged from three to 22 months. The women were grouped into ages 40 to 49, 50 to 59, 60 to 69, and 70 and older. The data included rates per 1,000 screens for recalls, biopsies, cancers, and invasive cancers detected.

The results showed that 278,908 women underwent digital mammography images alone and 173,414 women underwent digital mammography plus tomosynthesis. The researchers found that when tomosynthesis was added to digital mammography, there were significant reductions in recall rates for all age groups and significant increases in cancer detection rates for women 40 to 69 years old. The largest recall rate reduction with tomosynthesis was for women who were 40 to 49 years old, decreasing from 137 to 115, for a difference of −22. There was also a simultaneous increase in invasive cancer detection rate with the addition of tomosynthesis in the 40 to 49 age group, from 1.6 to 2.7.

The researchers concluded that by adding tomosynthesis to digital mammography, there was an increase in invasive cancer detection rates for women age 40 to 69 and a decrease in recall rates for all age groups, with largest performance gains seen also in women aged 40 to 49.

“The similar performance seen with tomosynthesis screening for women in their 40s compared to digital mammography for women in their 50s argues strongly for commencement of mammography screening at age 40 using tomosynthesis,” they wrote.