Go Back
This abstract was viewed 63 times

Original research article

Initial experience with combination digital breast tomosynthesis plus full field digital mammography or full field digital mammography alone in the screening environment.

Stamatia DestounisAndrea ArienoRenee Morgan
Date of Submission: 22-Nov-2013, Date of Acceptance: 22-Jan-2014, Date of Web Publication: 25-Feb-2014.
Corresponding Author:
Corresponding Author

Stamatia Destounis

Elizabeth Wende Breast Care, LLC, 170 Sawgrass Dr. Rochester, New York.
E-mail: sdestounis@ewbc.com

Corresponding Author:
Corresponding Author

Stamatia Destounis

Elizabeth Wende Breast Care, LLC, 170 Sawgrass Dr. Rochester, New York.
E-mail: sdestounis@ewbc.com

DOI: 10.4103/2156-7514.127838 Facebook Twitter Google Linkedin


Objectives: Initial review of patients undergoing screening mammography imaged with a combination of digital breast tomosynthesis (DBT) plus full field digital mammography (FFDM) compared with FFDM alone.
Materials and Methods: From June 2011 to December 2011, all patients presenting for routine screening mammography were offered a combination DBT plus FFDM exam. Under institutional review board approval, we reviewed 524 patients who opted for combination DBT plus FFDM and selected a sample group of 524 FFDM screening exams from the same time period for a comparative analysis. The χ2 (Chi-square) test was used to compare recall rates, breast density, personal history of breast cancer, and family history of breast cancer between the two groups.
Results: Recall rate for FFDM, 11.45%, was significantly higher (P < 0001) than in the combination DBT plus FFDM group (4.20%). The biopsy rate in the FFDM group was 2.29% (12/524), with a cancer detection rate of 0.38% (2/524, or 3.8 per 1000) and positive predictive value (PPV) of 16.7% (2/12). The biopsy rate for the DBT plus FFDM group was 1.14% (n = 6/524), with a cancer detection rate 0.57% (n = 3/524, or 5.7 per 1000) and PPV of 50.0% (n = 3/6). Personal history of breast cancer in the FFDM group was significantly lower (P < 0.0001) than in the combination DBT plus FFDM group; 2.5% and 5.7%, respectively. A significant difference in family history of breast cancer (P < 0.0001) was found, with a higher rate in the combination DBT plus FFDM group (36.0% vs. 53.8%). There was a significant difference between the combination DBT plus FFDM group and FFDM alone group, when comparing breast density (P < 0.0147, 61.64% vs. 54.20% dense breasts, respectively) with a higher rate of dense breasts in the DBT plus FFDM group. In follow-up, one cancer was detected within one year of normal screening mammogram in the combination DBT plus FFDM group.
Conclusion: Our initial experience found the recall rate in the combination DBT plus FFDM group was significantly lower than in the FFDM alone group, despite the fact that the combination DBT plus FFDM group had additional risk factors.
Keywords: Breast Imaging, Digital Breast Tomosynthesis, Screening Mammography

Cited in 24 Documents

  1. Mayuresh Kulkarni, Ronald Dendere, Fred Nicolls and Tania S. Douglas (2016) Monte-Carlo simulation of a slot-scanning digital mammography system for tomosynthesis. XST 24(2):191. doi: 10.3233/XST-160543
  2. Etta D. Pisano (2018) Is Tomosynthesis the Future of Breast Cancer Screening?. Radiology 287(1):47. doi: 10.1148/radiol.2018172953
  3. Pierpaolo Pattacini, Andrea Nitrosi, Paolo Giorgi Rossi, Valentina Iotti, Vladimiro Ginocchi, Sara Ravaioli, Rita Vacondio, Luca Braglia, Silvio Cavuto and Cinzia Campari (2018) Digital Mammography versus Digital Mammography Plus Tomosynthesis for Breast Cancer Screening: The Reggio Emilia Tomosynthesis Randomized Trial. Radiology 288(2):375. doi: 10.1148/radiol.2018172119
  4. Martin Sonnenschein and Christian Waldherr (2017) Atlas of Breast Tomosynthesis. (Chapter 4):187. doi: 10.1007/978-3-319-21566-2_4
  5. Stamatia Destounis and Amanda Santacroce (2018) Age to Begin and Intervals for Breast Cancer Screening: Balancing Benefits and Harms. American Journal of Roentgenology 210(2):279. doi: 10.2214/AJR.17.18730
  6. M. Luke Marinovich, Petra Macaskill, Daniela Bernardi and Nehmat Houssami (2018) Systematic review of agreement between tomosynthesis and pathologic tumor size for newly diagnosed breast cancer and comparison with other imaging tests. Expert Review of Medical Devices 15(7):489. doi: 10.1080/17434440.2018.1491306
  7. Alice Chong, Susan P. Weinstein, Elizabeth S. McDonald and Emily F. Conant (2019) Digital Breast Tomosynthesis: Concepts and Clinical Practice. Radiology :180760. doi: 10.1148/radiol.2019180760
  8. Matthew Alcusky, Liane Philpotts, Machaon Bonafede, Janice Clarke and Alexandria Skoufalos (2014) The Patient Burden of Screening Mammography Recall. Journal of Women's Health 23(S1):S-11. doi: 10.1089/jwh.2014.1511
  9. Per Skaane (2017) Breast cancer screening with digital breast tomosynthesis. Breast Cancer 24(1):32. doi: 10.1007/s12282-016-0699-y
  10. Kun‐Mu Lu, Da‐Ming Yeh, Bi‐Hui Cao, Chia‐Yi Lin, Chih‐Yu Liang, Yu‐Bo Zhou and Chia‐Jung Tsai (2019) Quantitative evaluation of breast density using a dual‐energy technique on a digital breast tomosynthesis system. J Appl Clin Med Phys :. doi: 10.1002/acm2.12618
  11. Luca A. Carbonaro, Giovanni Di Leo, Paola Clauser, Rubina M. Trimboli, Nicola Verardi, Maria P. Fedeli, Rossano Girometti, Alfredo Tafà, Paola Bruscoli, Gianni Saguatti, Massimo Bazzocchi and Francesco Sardanelli (2016) Impact on the recall rate of digital breast tomosynthesis as an adjunct to digital mammography in the screening setting. A double reading experience and review of the literature. European Journal of Radiology 85(4):808. doi: 10.1016/j.ejrad.2016.01.004
  12. Evan L. Honig, Lisa A. Mullen, Tali Amir, Matthew D. Alvin, Mary K. Jones, Emily B. Ambinder, Eniola T. Falomo and Susan C. Harvey (2019) Factors Impacting False Positive Recall in Screening Mammography. Academic Radiology :. doi: 10.1016/j.acra.2019.01.020
  13. Elodia B. Cole and Etta D. Pisano (2016) Tomosynthesis for breast cancer screening. Clinical Imaging 40(2):283. doi: 10.1016/j.clinimag.2015.09.014
  14. (2018) Breast Tomosynthesis. 243. doi: 10.1016/B978-0-323-35827-9.16001-0
  15. Robert Hodgson, Sylvia H. Heywang-Köbrunner, Susan C. Harvey, Mary Edwards, Javed Shaikh, Mick Arber and Julie Glanville (2016) Systematic review of 3D mammography for breast cancer screening. The Breast 27:52. doi: 10.1016/j.breast.2016.01.002
  16. Stamatia Destounis (2018) Role of Digital Breast Tomosynthesis in Screening and Diagnostic Breast Imaging. Seminars in Ultrasound, CT and MRI 39(1):35. doi: 10.1053/j.sult.2017.08.002
  17. TajammalAbbas Shah and ShaistaSalman Guraya (2017) Breast cancer screening programs: Review of merits, demerits, and recent recommendations practiced across the world. J Microsc Ultrastruct 5(2):59. doi: 10.1016/j.jmau.2016.10.002
  18. N. Upadhyay, N. Soneji, V. Stewart and G. Ralleigh (2018) The effect of the addition of tomosynthesis to digital mammography on reader recall rate and reader confidence in the UK prevalent screening round. Clinical Radiology 73(8):744. doi: 10.1016/j.crad.2018.03.013
  19. Stamatia V. Destounis, Renee Morgan and Andrea Arieno (2015) Screening for Dense Breasts: Digital Breast Tomosynthesis. American Journal of Roentgenology 204(2):261. doi: 10.2214/AJR.14.13554
  20. Sean D. Raj, Valerie Fein-Zachary and Priscilla J. Slanetz (2018) Deciphering the Breast Density Inform Law Movement: Implications for Practice. Seminars in Ultrasound, CT and MRI 39(1):16. doi: 10.1053/j.sult.2017.08.001
  21. Anthony J. Maxwell, Michael Michell, Yit Y. Lim, Susan M. Astley, Mary Wilson, Emma Hurley, D. Gareth Evans, Anthony Howell, Asif Iqbal, John Kotre, Stephen Duffy and Julie Morris (2017) A randomised trial of screening with digital breast tomosynthesis plus conventional digital 2D mammography versus 2D mammography alone in younger higher risk women. European Journal of Radiology 94:133. doi: 10.1016/j.ejrad.2017.06.018
  22. Stamatia Destounis and Jennifer L. Gruttadauria (2015) An Overview of Digital Breast Tomosynthesis. Journal of Radiology Nursing 34(3):131. doi: 10.1016/j.jradnu.2014.10.004
  23. M Luke Marinovich, Kylie E Hunter, Petra Macaskill and Nehmat Houssami (2018) Breast Cancer Screening Using Tomosynthesis or Mammography: A Meta-analysis of Cancer Detection and Recall. 110(9):942. doi: 10.1093/jnci/djy121
  24. Tong Li, Michael Luke Marinovich and Nehmat Houssami (2018) Digital breast tomosynthesis (3D mammography) for breast cancer screening and for assessment of screen-recalled findings: review of the evidence. Expert Review of Anticancer Therapy 18(8):785. doi: 10.1080/14737140.2018.1483243

This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.