Abstract
Objectives:Initial review of patients undergoing screening mammography imaged with a combination of digital breast tomosynthesis (DBT) plus full field digital mammography (FFDM) compared with FFDM alone.Materials and Methods:From June 2011 to December 2011, all patients presenting for routine screening mammography were offered a combination DBT plus FFDM exam. Under institutional review board approval, we reviewed 524 patients who opted for combination DBT plus FFDM and selected a sample group of 524 FFDM screening exams from the same time period for a comparative analysis. The χ2 (Chi-square) test was used to compare recall rates, breast density, personal history of breast cancer, and family history of breast cancer between the two groups.Results:Recall rate for FFDM, 11.45%, was significantly higher (P < 0001) than in the combination DBT plus FFDM group (4.20%). The biopsy rate in the FFDM group was 2.29% (12/524), with a cancer detection rate of 0.38% (2/524, or 3.8 per 1000) and positive predictive value (PPV) of 16.7% (2/12). The biopsy rate for the DBT plus FFDM group was 1.14% (n = 6/524), with a cancer detection rate 0.57% (n = 3/524, or 5.7 per 1000) and PPV of 50.0% (n = 3/6). Personal history of breast cancer in the FFDM group was significantly lower (P < 0.0001) than in the combination DBT plus FFDM group; 2.5% and 5.7%, respectively. A significant difference in family history of breast cancer (P < 0.0001) was found, with a higher rate in the combination DBT plus FFDM group (36.0% vs. 53.8%). There was a significant difference between the combination DBT plus FFDM group and FFDM alone group, when comparing breast density (P < 0.0147, 61.64% vs. 54.20% dense breasts, respectively) with a higher rate of dense breasts in the DBT plus FFDM group. In follow-up, one cancer was detected within one year of normal screening mammogram in the combination DBT plus FFDM group.Conclusion:Our initial experience found the recall rate in the combination DBT plus FFDM group was significantly lower than in the FFDM alone group, despite the fact that the combination DBT plus FFDM group had additional risk factors.
Highlights
Mammography is the Gold Standard for breast cancer detection and diagnosis, as it has been shown to reduce breast cancer mortality at a rate of 15%-35%.[1]
There was a significant difference between the combination Digital breast tomosynthesis (DBT) plus full field digital mammography (FFDM) group and FFDM alone
We report our preliminary experience with patients undergoing screening mammography imaged with combination DBT plus FFDM compared with FFDM alone
Summary
Mammography is the Gold Standard for breast cancer detection and diagnosis, as it has been shown to reduce breast cancer mortality at a rate of 15%-35%.[1]. The only unit to date that has Food and Drug Administration (FDA) approval is a DBT unit that uses a flat panel detector and tube rotation that makes one sweep over the compressed breast. This motion produces a series of projections at different angles creating a three‐dimensional (3D) image of the breast that can be reconstructed into a series of slices.[5] The unit can be used for standard full field digital mammography (FFDM) imaging, or combination DBT plus FFDM imaging. As DBT is still in the early phases of implementation, research is ongoing to determine the role this technology will have in the clinical setting: Routine screening mammography or diagnostic evaluation
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