DBT helps reduce recall rates, commit fewer patients to short-term follow-up

Implementing digital breast tomosynthesis (DBT) can lead to fewer women being committed to short-term follow-up, according to new research published in Academic Radiology.

The authors explored BI-RADS classifications from a single institution that first made DBT available in September 2011. More than 11,000 breast cancer screening examinations with digital mammography (DM) from before implementation (Sept. 1, 2010 to August 31, 2011) were compared with more than 9,000 examinations with DBT and DM after implementation (Jan. 1, 2014 to June 30, 2015). All examinations were read by one of a team of five radiologists.

The authors found that BI-RADS Category 0 classifications (“additional imaging needed”) dropped from 13 percent of examinations to 11.8 percent, a clear shift in the institution’s recall rate. Also, BI-RADS Category 3 classifications (“probably benign”) dropped from 3.4 percent of examinations to 2.4 percent. The overall number of patients assigned to short-term follow-up was reduced by 10.3 women per 1,000 women.

“This reduction in the number of women committed to short-term follow-up has the potential for downstream effects including decreased patient anxiety, improved patient outcomes, and decreased false positive mammograms,” wrote co-author Tricia Stepanek, Case Western Reserve University School of Medicine in Cleveland, Ohio, and colleagues. “In addition, the increased cost savings of avoiding follow-up diagnostic imaging is likely to outweigh the initial cost of DBT with screening.”

The authors did note that the combination of DM and DBT exposes patients to more radiation. In addition, a limitation of the study was that it only covered patients seeking care from a single institution.