Across Multiple Screening Rounds, Digital Breast Tomosynthesis Has Lower Recall Rates and Detects More Cancers Than Digital Mammography

New BCSC study examines DBT performance metrics on successive screening rounds

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Digital breast tomosynthesis (DBT) has been widely adopted for breast cancer screening, comprising 46% of the U.S. Food and Drug Administration–accredited mammography units as of October 2022.  DBT dissemination has been supported by studies reporting a higher cancer detection rate and lower recall rate compared with digital mammography (DM) screening examinations, but most DBT examinations included in these studies have been the woman’s first DBT examination.  A new study from the Breast Cancer Surveillance Consortium examined the performance of DBT vs. DM screening on successive screening rounds, using data on 523,485 DBT and 1,008,123 DM screening examinations from 58 breast imaging facilities at five regional breast imaging registries.  The results showed that DBT had lower recall rate than DM through three screening rounds, and a higher cancer detection rate at round 3 or above.  No differences were observed for DBT vs. DM on any screening round for rates of interval cancer or advanced cancer.  These findings provide new evidence for women, health care providers, and policymakers evaluating the benefits, harms, and limitations of multiple rounds of breast cancer screening with DBT compared with DM. Overall, the results provide support for further dissemination of DBT, tempered by continued uncertainty regarding the effect of DBT on screening failure rates, overdiagnosis, and breast cancer mortality.

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Posted by: Brian Sprague