Tomosynthesis May Enhance Digital Mammography — But Is There a Trade-Off?

Adjunctive tomosynthesis increased detection of invasive and in situ breast cancers in a randomized trial; however, the question of overdiagnosis remains unanswered.

Digital breast tomosynthesis (DBT) is an FDA-approved adjunct to digital mammography (DM) that produces a three-dimensional image. DBT is more sensitive than standard DM — but its benefits for cancer mortality in the context of the potential harms of overdiagnosis remain unclear.

In a randomized trial, researchers in Italy compared DM alone versus with DBT for screening >19,500 women (age range, 45–74) from 2014 to 2016. Results of a planned interim analysis showed that, at baseline, recall rates were similar in both groups (3.5%). However, the cancer detection rate was higher with DBT than with DM (relative risk, 1.89), the positive predictive value was higher in the DBT group (24.1 vs. 13.0), and the false-positive rate was lower (RR, 0.89…

Reviewing Author

Laila Samiian, MD, FACS

Disclosures

Leadership Positions in Professional SocietiesAssociation of Women Surgeons (Member, Publications Committee)

Laila Samiian, MD, FACS

Disclosures

Leadership Positions in Professional SocietiesAssociation of Women Surgeons (Member, Publications Committee)

Tomosynthesis May Enhance Digital Mammography — But Is There a Trade-Off?

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Reviewing Author