Tomosynthesis Disadvantages

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A snapshot of the evidence Several retrospective studies investigating tomosynthesis as a breast cancer screening tool have been conducted in the U. and all have demonstrated that DBT in combination with DM diminishes recall rates versus DM alone.

Most of these studies also found an increase in breast cancer detection rates when DBT is employed in conjunction with DM.

Synthetic 2D mammography, when compared with DM-DBT and DM alone, “showed an additional improved clinical performance in regards to false positives and callbacks, while maintaining cancer detection rates,” comments Dr. “The synthetic 2D mammogram is suitable for interpretation, while forgoing the additional radiation exposure to obtain a readable 2D image.

It’s a potential game-changer.” What to watch out for in DBT As the use of DBT as a screening tool continues to grow, clinicians should be aware of the potential concerns and limitations surrounding this technology.

As a multitude of published studies suggest, the addition of tomosynthesis to DM significantly lowers recall rates and improves cancer detection, says Jacqueline Holt, MD, Director of Breast Imaging at the Helen F.

Food and Drug Administration (FDA) in 2011, this imaging technology, also referred to as 3D mammography, has been increasingly integrated into clinical practice across the U. and around the world as an adjunct to standard 2-view digital screening mammography (DM).One study in particular, by Rafferty and colleagues, investigated the effect of age on breast cancer detection when DBT is used in combination with DM.Screening performance measures from 13 institutions were compared and analyzed by age group among 278,908 women who were screened with DM alone and 173,414 who underwent screening with DM plus DBT. The addition of DBT to DM significantly increased the invasive cancer detection rate for women 40 to 69 years of age, with rates increasing from 1.6% to 2.7% for women in the 40 to 49 age group.Another view: synthetic 2D mammography Despite its benefits, DBT added to DM for screening can more than double the radiation dose to the breast.FDA-approved in 2013, synthetic 2D mammography mitigates this problem by generating simulated DM images from DBT scans, thereby avoiding the additional radiation exposure. Holt, retrospectively collected 32,076 DM, 30,561 DM-DBT, and 16,173 DBT-synthetic 2D screening mammograms from a large community-based cancer center, and analyzed the diagnostic performance of each modality.This increase mainly included invasive cancers, not ductal carcinoma in situ, “which is important given current concerns for potential overdiagnosis and overtreatment,” wrote Steven Poplack, MD, in a 2017 review summarizing clinical DBT data.“It has been fairly well established that, when used in the screening setting, tomosynthesis decreases recalls,” comments Carol Lee, MD, a diagnostic radiologist at Memorial Sloan Kettering Cancer Center in New York. Wiley Online Library requires cookies for authentication and use of other site features; therefore, cookies must be enabled to browse the site.Detailed information on how Wiley uses cookies can be found in our Privacy Policy.In a recent meta-analysis of 11 eligible trials, Yun and colleagues sought to examine the utility of DBT in improving breast cancer detection as a function of pathological characteristics.On the basis of random effects models, DM plus DBT versus DM alone was shown to yield greater cancer detection for invasive breast cancer overall—and ductal, lobular, grade I to III, nodal-negative, and stage T1 tumors in particular—but not for carcinoma in situ or stage ≥T2 or nodal-positive tumors.

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