3D mammograms offer advantage for women 65 and older

  • Bahl M & al.
  • Radiology
  • 2 Apr 2019

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

  • In elderly women (aged ≥65 years), digital breast tomosynthesis (DBT) outperforms digital mammography (DM) on several performance metrics: lower abnormal interpretation rate, higher positive predictive value, and higher specificity.
  • There was no difference between groups in breast cancer (BCa) detection rate, but this finding may have been confounded by performance over time.

Why this matters

  • This is the first study to compare DBT vs DM in elderly women.
  • Findings support adoption of DBT for first-line screening in elderly women.

Study design

  • Retrospective cohort comparing performance metrics in women aged ≥65 years undergoing DBT (n=20,646) vs DM (n=15,019) at Massachusetts General Hospital during 2008-2011.
  • Funding: None disclosed.

Key results

  • DM and DBT offered similar cancer detection rates (6.9 vs 8.2 per 1000 exams; aOR, 1.13; P=.23).
  • DBT performed better than DM on the following:
    • Lower abnormal interpretation rate (5.7% vs 5.8%; aOR, 0.88; P<.001>
    • Higher positive predictive value 1 (14.5% vs 11.9%; aOR, 1.26; P=.03);
    • Higher specificity (95.1% vs 94.8%; aOR, 1.18; P<.001>
  • Marginal advantage for DBT was observed in proportion of:
    • Invasive cancers vs in situ cancers (81.1% vs 74.4%, respectively; P=.06).
    • Node-positive cancers (10.2% vs 16.6%; P=.054).

Limitations

  • Single-center study.