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Impact of the Addition of Digital Breast Tomosynthesis (DBT) to Standard 2D Digital Screening Mammography on the Rates of Patient Recall, Cancer Detection, and Recommendations for Short-term Follow-up. | LitMetric

AI Article Synopsis

  • The study evaluates the effects of adding digital breast tomosynthesis (DBT) to standard digital mammography (DM) on recall rates and short-term follow-up for breast cancer screening.
  • Results show that DBT led to lower recall rates, higher biopsy rates, and a notable increase in cancer detection, including ductal carcinoma in situ.
  • Researchers found an 80% increase in short-term follow-up rates for probably benign findings with DBT, indicating a need for further research on follow-up protocols to balance cancer detection with cost and patient anxiety.

Article Abstract

Rationale And Objectives: The addition of digital breast tomosynthesis (DBT) to digital screening mammography (DM) has been shown to decrease recall rates and improve cancer detection rates, but there is a lack of data regarding the impact of DBT on rates of short-term follow-up. We assessed possible changes in performance measures with the introduction of DBT at our facility.

Materials And Methods: In our observational study, databases were used to compare rates of recall, short-term follow-up, biopsy, and cancer detection between women undergoing DM without (n = 10,477) and women undergoing DM with (n = 2304) the addition of DBT. Regression analysis was performed to determine associations with patient age, breast density, and availability of comparison examinations.

Results: The addition of DBT resulted in significantly lower recall rates (16%-14%, P = .017), higher rates of biopsy (12.7%-19.1%, P < .01), and increased detection of ductal carcinoma in situ, with a difference of 2.3 cases per 1000 screens (P = .044). A 33% increase in cancer detection rates was observed with DBT, which did not reach statistical significance. Short-term follow-up of probably benign findings was 80% higher in the DBT group (odds ratio = 1.80, 95% confidence interval = 1.38-2.36, P < .001).

Conclusions: To our knowledge, we are the first to study the impact of DBT on rates of short-term follow-up, and observed an 80% increase over the DM group. Further research is needed to determine the malignancy rate of Breast Imaging Reporting and Data System 3 lesions detected with DBT, and establish appropriate follow-up to maximize cancer detection while minimizing expense and patient anxiety.

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Source
http://dx.doi.org/10.1016/j.acra.2016.10.001DOI Listing

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