3D mammography adoption triples in 3 years

  • JAMA Intern Med

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

  • Adoption of digital breast tomosynthesis (DBT; also known as 3D mammography) into clinical practice has been rapid, jumping from 12.9% to 43.2% of mammography screenings during a recent 3-year period.

Why this matters

  • DBT appears to have a lower recall rate and higher cancer detection rate, which is offset by higher cost and higher radiation dose with some machines.

Study design

  • Longitudinal analysis of nearly 9.7 million screening claims in a US private health insurance database (Blue Cross Blue Shield or BCBS) from January 1, 2015, to December 31, 2017.
  • To assess the generalizability of the findings, BCBS claims for DBT were compared with those of Medicare fee-for-service, according to hospital referral region (HRR).
  • Funding: NIH; American Cancer Society.

Key results

  • DBT use rose from 12.9% to 43.2% of screening claims during the 3-year study period.
  • DBT as the predominant mode of screening (i.e., used in >50% of mammography screenings) grew from 4.6% of HRRs to 41.8% of HRRs during the same period.
  • HRR-level use of DBT in the BCBS population was strongly correlated with that in the Medicare population (r, 0.85 in 2015 [P<.001 r in>
  • Most rapid growth was in the Northeast and Northwest United States.

Limitation

  • Reliance on claims data.