Combo of DBT and 2D mammography better for breast cancer screening than DM alone: Study
Germany: Digital breast tomosynthesis (DBT) combined with synthesized 2D mammography leads to higher cancer detection rates and lower recall versus digital mammography (DM) alone, finds a recent study. The study was published in the journal European Radiology on 25th October 2021.
"Our study showed that diagnostic outcomes improved with the combo of DBT plus s2D compared to DM alone and emphasized on the value of the combo in breast cancer screening," the researchers wrote. "To our best knowledge, this is the first meta-analysis of biopsy rates, PPV-2, and PPV-3 in women screened with DBT plus s2D compared to DM alone."
Previous studies have shown DBT plus DM to be problematic in screening due to increased radiation by double exposure. s2D calculated from DBT datasets at no additional dose appears a sensible alternative compared to adding DM. A team led by Sylvia H. Heywang-Köbrunner, FFB gGmbH, Munich, Germany, therefore, aimed to evaluate the screening performance outcomes in women screened with DBT plus s2D compared to DM alone.
For this purpose, the researchers searched the online databases from January 1, 2010, to September 2, 2020. It included studies comparing DBT plus s2D to DM alone in breast cancer screening. They estimated pooled risk ratios (RR) for cancer detection rates (CDR), recall rates, interval cancer rates (ICR), biopsy rates, and positive predictive values for recalls (PPV-1), for biopsies recommended (PPV-2), and for biopsies performed (PPV-3).
Twelve papers covering 414,281 women were included from 766 records identified.
Key findings include:
- CDR is increased ([RR, 95% CI] 1.35, 1.20–1.52), recall rates are decreased (0.79, 0.64–0.98), and PPV-1 is increased (1.69, 1.45–1.96) when using DBT plus s2D compared to DM alone.
- ICR and biopsy rates did not differ, but PPV-2 respectively PPV-3 increased with DBT plus s2D (1.57, 1.08–2.28 respectively 1.36, 1.17–1.58).
- Overall RoB of studies was assessed to be low.
The researchers concluded, "results show improved diagnostic outcomes with DBT plus s2D compared to DM alone and underline the value of DBT in combination with s2D in breast cancer screening."
Reference:
Heywang-Köbrunner, S.H., Jänsch, A., Hacker, A. et al. Digital breast tomosynthesis (DBT) plus synthesised two-dimensional mammography (s2D) in breast cancer screening is associated with higher cancer detection and lower recalls compared to digital mammography (DM) alone: results of a systematic review and meta-analysis. Eur Radiol (2021). https://doi.org/10.1007/s00330-021-08308-8
