New Breast Screening Techniques Increases Diagnostic Accuracy

Research in Radiology reported that the addition of three-dimensional breast imaging (tomosynthesis) to standard digital mammography significantly increases the diagnostic accuracy by the radiologist and reduces false positive recall rates. The researchers said “this is the first major advances in breast imaging and breast cancer screening since the development of breast MRI.” “The beauty of tomosynthesis is that it addresses two major concerns with screening mammograms: missed cancers and false positives. ” Previously , as many as 30 percent of breast cancers were not detected and an additional 8 to 10 percent had to be recalled for further testing.

In the study 1,192 women from five sites, of whom 997 (780 screening cases and 217 women needing biopsy breast imaging) had complete data sets. Each woman had a standard digital mammogram followed by breast tomosynthesis involving a total of less than 3 milligram of radiation dose which is the FDA limit for a single mammogram. Two reader studies were carried out on 312 and 310 cases respectively.  Twelve radiologists participated in the first reader study, and 15 in the second.  A total of 48 cancers were included in the first reader study and 51 cancers in the second.

Compared to digital mammography alone, using both standard mammography and tomosynthesis resulted in increased diagnostic accuracy for all 27 radiologists. In addition, the rate at which cancer present in the breast was correctly identified increased by 10.7 percent for the radiologists in Reader Study 1 and 16 percent for radiologists in Reader Study 2. The researcher said “Almost all of the gains in diagnostic sensitivity with the combined modalities were attributed to the improved detection and characterization of invasive cancers, which are the cancers we are most concerned about because of their potential to metastasize.”

In addition, the combined modalities compared to standard digital mammography  significantly reduced the false positive recall rate for all 27 radiologists by 38.6 percent and 17.1 percent in Reader Study 1 and 2 respectively.

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