3D mammography tied to lower recall, higher cancer detection rates

  • Sprague BL & al.
  • JAMA Netw Open
  • 2 Mar 2020

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

  • Digital breast tomosynthesis (DBT; also known as 3D mammography) is associated with a 15% lower recall rate and a 21% higher cancer detection rate than digital mammography (DM), according to a large cohort study.

Why this matters

  • Many radiologists have screening mammography recall rates higher than the American College of Radiology recommended threshold of 12%.

Study design

  • Retrospective cohort of screening mammography exams by 198 radiologists (from 104 radiology facilities in the Breast Cancer Surveillance Consortium) who interpreted 251,384 DBT and 2,000,681 DM exams (2009-2017).
  • Funding: Patient-Centered Outcomes Research Institute; NIH; others.

Key results

  • With DM, 65.9% of the radiologists had an unadjusted recall rate of no more than 12%, with a median of 10.0% (interquartile range [IQR], 7.5%-13.0%).
  • With DBT, 76.2% had an unadjusted recall rate of no more than 12%, with a median of 8.8% (IQR, 6.3%-11.3%).
  • DBT vs DM was associated with a 15% lower recall rate after adjusting for secular trends and examination characteristics, with a relative risk of 0.85 (95% CI, 0.83-0.87).
  • DBT vs DM also was associated with a 21% increase in cancer detection rate (multivariable-adjusted risk ratio, 1.21; 95% CI, 1.11-1.33).

Limitations

  • Observational.
  • Secular trend in recall rates (decline of 1.2% per year).