3-D mammography improves cancer detection in dense breasts

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Takeaway

  • In women with dense breasts, digital breast tomosynthesis (DBT, also known as 3-D mammography) ± digital mammography (DM) is superior to DM alone for breast cancer detection in both diagnostic and screening settings.
  • DBT may also be superior in reducing the recall rate.

Why this matters

  • Findings favor use of DBT±DM over DM alone for women with dense breasts.

Study design

  • Meta-analysis of 16 studies (n=5 diagnostic studies; n=11 screening studies) that met eligibility criteria after search of PubMed and Web of Science.
  • Funding: None.

Key results

  • In diagnostic studies, DBT showed increased sensitivity (84%-89%) vs DM (69%-86%), but specificity was similar.
  • In diagnostic studies, DBT±DM raised the cancer detection rate (CDR) vs DM (risk ratio [RR], 1.12; 95% CI, 1.01-1.24).
  • In screening studies, DBT±DM raised the CDR vs DM (RRs, 1.33 [95% CI, 1.20-1.47] for retrospective studies and 1.52 [95% CI, 1.08-2.11] for prospective studies).
  • In screening studies, the recall rate was lower with DBT±DM vs DM alone in retrospective studies (RR, 0.72; 95% CI, 0.64-0.80) but not prospective studies (RR, 1.12; 95% CI, 0.76-1.63).

Limitations

  • Heterogeneity across studies.
  • Most studies used a single DBT screening.