3D mammogram shows benefit in breast cancer staging

  • Fontaine M & al.
  • Radiology
  • 9 Apr 2019

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

  • Adding digital breast tomosynthesis (DBT, also known as 3D mammogram) to digital mammography (DM) improves detection of ipsilateral and contralateral disease during staging of newly diagnosed breast cancer.

Why this matters

  • DBT has shown benefit in cancer screening, but there are limited data on adjunctive use during staging of known disease.
  • Benefit restricted to women with nondense breasts.

Study design

  • 4 radiologists independently reviewed DM and DM+DBT images from 166 patients with breast cancer aged >40 years (mean, 59.5±11 years) with mammographic
    Breast Imaging Reporting and Data Systems (BI-RADS) category
    4 or 5 lesions.
  • Breast MRI and pathologic verifications were used as reference standards.
  • Funding: Hologic France.

Key results

  • DM+DBT (vs DM) had higher sensitivity for diagnosis of multicentric (51% vs 37%; P=.002) and additional ipsilateral (52% vs 44%; P=.007) lesions.
  • DM+DBT (vs DM) had greater diagnostic performance in the assessment of bilateral breast cancer (area under the receiver operating characteristic curve [AUC], 0.74 vs 0.67; P=.02).
  • DM+DBT (vs DM) had greater diagnostic performance (for nondense breasts only) in the assessment of ipsilateral lesions (AUC, 0.74 vs 0.70; P=.04) and contralateral lesions (0.76 vs 0.68; P=.02).

Limitations

  • Potential overestimation of imaging sensitivity in index tumor diagnosis.

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