The combination of digital breast tomosynthesis (DBT) and synthetic 2D imaging increases cancer detection rates (CDRs) compared to just full-field digital mammography (FFDM), according to a new study published in Radiology.

The authors studied more than 16,000 asymptomatic women ages 50-69 who received DBT plus synthetic 2D mammography from April 2015 to March 2016 through the Breast Cancer Screening Program in Verona, Italy. They then compared those patients with data from more than 14,000 women who were screened through the same program with FFDM in the previous year.

Overall, they found that the CDR for DBT plus synthetic 2D imaging was 9.3 per 1,000 exams. For FFDM, that number was 5.41 per 1,000 exams. In addition, among women with both low breast density and high breast density, the CDR for DBT plus synthetic 2D imaging was “significantly higher” than those screened with FFDM.

“There was evidence of improved cancer detection with DBT plus synthetic 2D imaging across age groups, with significant differences for women older than 55 years, further highlighting the effectiveness of DBT in terms of cancer detection for women in this age group,” wrote lead author Francesca Caumo, MD, of Ospedale di Marzana in Verona, Italy, and colleagues. “DBT plus synthetic 2D imaging also significantly improved cancer detection in all density-stratified analyses.”

Caumo et al. also found that the mean number of studies interpreted per hour was much less with DBT plus synthetic 2D imaging (38.5 per hour) than FFDM (60 per hour). “There are more section images to be read when DBT is used, and image loading times are slower,” the authors wrote. “The increased reading workload could be balanced by a reduction in the number of second-level work-ups or, alternatively, by elimination of double reading.”