DBT associated with lower recall rate, makes no impact on cancer detection rate

The implementation of digital breast tomosynthesis (DBT) at eight radiology facilities in Vermont led to lower recall rates than full-field digital mammography (FFDM) alone, according to a new study published in the American Journal of Roentgenology. However, the authors observed no improvements in cancer detection rates.

The authors explored data from the Vermont Breast Cancer Surveillance system, including more than 97,000 FFDM examinations and more than 86,000 DBT examinations from 2012 through 2016.

Screening with DBT was found to have a recall rate of 7.9 percent, and FFDM alone had a recall rate of 10.9 percent. The biopsy rate between the two methods was “very similar” while the benign biopsy rate and cancer detection rate associated with DBT were both “effectively equivalent to FFDM after statistical adjustment for covariates.”

“It is unclear why increased cancer detection with DBT screening was not experienced in Vermont,” the study's authors wrote. “One potential contributing factor is the relatively high cancer detection rate on FFDM screening examinations in this study (5.6 per 1000 examinations). Studies reporting increased cancer detection with DBT in the United States have had comparison FFDM cancer detection rates of less than 5 per 1000 examinations.”

These findings, the authors added, could mean that providers already delivering high cancer detection rates with FFDM may not necessarily see rates drop even more due to DBT implementation. They also said additional research is needed to further explore this topic.

“Our finding of no elevated cancer detection on DBT screening provides motivation for further research on factors associated with variability in the impact of DBT on cancer detection and other performance metrics,” the study's authors wrote. 

Prior coverage of another recent study focused on DBT implementation can be read here