3D mammogram shows advantage across breast density, age groups

  • Østerås BH & al.
  • Radiology
  • 13 Aug 2019

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Digital breast tomosynthesis (DBT, 3D mammogram) yielded a higher rate of true-positives and a lower rate of false-positives than digital mammography (DM, 2D mammogram) across most density and age groups in a large Norwegian cohort.

Why this matters

  • One of the largest cohorts to date unequivocally supports DBT over DM.

Study design

  • Prospective cohort (n=24,301 women aged 50-69 years) included in the Oslo Tomosynthesis Screening Trial.
  • Participants had both DM and DBT.
  • Participants were followed up to 2 years to detect tumors by 8 radiologists.
  • Breast density was rated from 1 (almost entirely fatty) to 4 (extremely dense) by automatic volumetric software.
  • Funding: Not disclosed.

Key results

  • DBT (vs DM) had higher true-positive rate for several density groups (differences ranged from 11.8% to 24.1%; P<.001 for density scores of and p>.05 for density scores of 1 and 4) and all 5-year age groupings (differences ranged from 15.3% to 35.0%; P<.05 for all age groups primarily because of the higher number spiculated masses and architectural distortions found with dbt.>
  • DBT (vs DM) had lower rate of false-positives in all density groups (differences ranged from −0.71% to −0.98%; P<.005 and age groups ranged from to p>

Limitations

  • Observational design.
  • Single-center study.