Adding digital breast tomosynthesis (DBT) to digital mammography (DM) in the prevalent screening round of a breast cancer screening program leads to a reduced recall rate and improved reader confidence, according to a new study published by Clinical Radiology.
“The prevalent round of screening could be a good candidate for the use of DBT, as mammograms from this round can be particularly challenging for readers, with previous mammograms often not available and a denser breast tissue more common,” wrote Neil Upadhyay from the imaging department at Imperial College Healthcare NHS Trust in London, and colleagues. “Diagnostic certainty decreases as the complexity of the mammographic pattern increases.”
The authors studied data from more than 800 women between the ages of 46 and 53 from the prevalent screening round of a breast screening program in the U.K., comparing the reader recall rates and reader confidence of DM alone with DM plus DBT.
Overall, the recall rate using DM alone was more than 17 percent. The recall rate using DM plus DBT was more than 11 percent, showing a relative reduction of 35 percent. Reductions in recall rate were seen in both patients with low breast density and patients with high breast density.
“To the authors' knowledge, this is the first study to demonstrate a reduction in reader recall rate when DBT is added to DM for women undertaking their initial screening mammogram, as part of a national breast screening program,” the authors wrote.
The median reader confidence rating in their recall decisions was seven out of 10 when using DM alone and eight out of 10 when using DM and DBT together.
“The relative familiarity with mammography compared with the newer DBT technique may account for the modest increase in confidence,” the authors wrote. “Previous studies have raised the possibility of a learning curve associated with DBT use. It is possible that reader confidence will increase if DBT is embedded in routine clinical practice.”
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