Implementing digital breast tomosynthesis (DBT) leads to lower breast biopsy rates without having a negative impact on cancer detection, according to new findings published in Radiology.
“The thin slice images of the breast taken with DBT reduce the effect of tissue overlap, which often leads to cancers being missed or to women who don’t have breast cancer being recalled for diagnostic imaging,” lead author Nisha Sharma, MBChB, of Leeds Teaching Hospital NHS Trust and Seacroft Hospital in Leeds, England, said in a prepared statement. “In our study, we wanted to determine the impact of DBT on the biopsy rate among women recalled for an abnormal screening mammogram.”
The authors explored data from more than 30,000 women who underwent either full-field digital mammography (FFDM) or breast MRI as part of a breast cancer screening program in the UK between Nov. 13, 2015, and July 29, 2016, and were then recalled. The patients also underwent DBT, allowing specialists to compare the results.
Overall, the screening program had a recall rate of 4.8 percent. After certain exclusions, the final recall group included 827 women with a mean age of 56.7. While 142 cancers were detected, the biopsy rate was 69 percent and the benign biopsy rate was 75 percent.
Sharma et al. found that adding DBT would have reduced the biopsy rate from 69 percent to 36 percent. Also, the benign biopsy rate would have dropped from 75 percent to 52 percent. All 142 cancers would have still been detected.
“DBT allows for improved reader accuracy and confidence in determining if a mammographic abnormality is concerning or not, leading to a reduction in the number of biopsies performed,” Sharma said in the same statement. “Our study validates that DBT can help in the diagnostic workup of mammographic abnormalities and reduce harm to women through fewer false positive biopsies without any reduction in the cancer detection rate.”