A research group from the University of Sydney compared 3D mammography and standard mammography screening of women in an effort to improve the results of breast cancer screening.
3D Mammogram Improvements
Overview of the Research
The University of Sydney study of 3D mammography, or tomosynthesis, has shown improvements in Detection, Recalls and Screen Reading Times when compared to standard mammography. The researchers looked at the effectiveness of the 3D mammography technique and found significant improvements, but also highlighted it is still too soon to celebrate if better detection may lead to overall better health outcomes for women.
A pilot trial of the 3D mammography findings were also published. The preliminary findings should serve as a strong basis for further large scale evaluations due to the trial showing favourable results.
10,146 women chose to participate, with 5166 standard mammography screens undertaken and 5018 3D mammography screens. The standard screens detected 34 cancers, the 3D screens detected 49 and differences were even greater when comparing repeat screens and the results of women over the age of 60.
This is the first Australian population-based trial of the effectiveness of digital breast tomosynthesis screening, and it was done in the BreastScreen Victoria program.
The participants were women over the age of 40 who presented for routine breast screening between August 2017 and November 2018 at the Maroondah BreastScreen service in Melbourne.
Method and Key Findings
From the study, the researchers found that:
- Tomosynthesis detected 49 cancers; Standard mammography detected 34 cancers
- With tomosynthesis, the estimated difference was 3.2 more detections per 1000 screens
- The Recall rate with tomosynthesis was 4.2% compared to 3% with Standard mammography
- The Screen Reading Time with tomosynthesis was 67 seconds compared to 16 seconds with Standard mammography
They suggested that the tomosynthesis screening is feasible to implement at BreastScreen Maroondah. It has a low opt-out rate, and could increase the breast cancer detection rate.
The researchers confirmed that there was more frequent detection by tomosynthesis screening than in standard mammography. But this could indicate it is more sensitive than standard mammography. The results are showing improvements, but may not yet suggest an improvement in overall health outcomes for women.
There are some disadvantages when using the tomosynthesis technique. Because of the amount of radiation exposure with tomosynthesis, the method should be carefully considered with each patient.
Another drawback can be the longer screen reading time, which needs to be considered when preparing for larger trials of tomosynthesis screening.
According to the authors, there are other factors worth keeping in mind such as:
- The imaging data and information infrastructure are important aspects to the success of tomosynthesis screening
- As this was a pilot trial, careful planning allowed for modifications that supported the implementation of tomosynthesis. Substantial changes may need to facilitate the use of the method in a higher volume population screening program
They further mentioned the future scope of study being a part of their limitations. The trial provided findings that could be further examined in larger, multi-service comparisons of tomosynthesis, including longer-term endpoints.
The balance between the benefits and harms of this new technology must be carefully assessed to ensure that it can be the most effective form of screening for Australian women.
What are your thoughts on the findings of the study? We would love to hear from you.
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