ARRS: Digital breast tomosynthesis slashes recall rates 40 percent

Adding digital breast tomosynthesis to 2D mammography screening results in a 40 percent reduction in patient recall rates compared to routine screening mammography alone, according to a study presented May 3 at the annual meeting of the American Roentgen Ray Society (ARRS) in Vancouver.

“In routine mammography, breast tissue is compressed and overlying tissue can look like a suspicious finding. Tomosynthesis resolves this by looking slice by slice,” Liane Philpotts, MD, of Yale University School of Medicine in New Haven, Conn., and one of the authors of the study, said in a statement.

Philpotts and colleagues compared screening mammography recall rates between women undergoing digital breast tomosynthesis and those undergoing 2D mammography alone after the introduction of tomosynthesis at their breast center. A total of 7,578 screening mammograms were interpreted during the study period.

The recall rate for the patients undergoing digital breast tomosynthesis was 6.6 percent, compared with 11.1 percent for 2D screening mammography alone. Similar recall rates were seen in both groups for masses, but there were significant differences for asymmetries and calcifications. When both screening techniques were used, the recall rate was 2.8 percent, compared with 7.1 percent for routine screening mammography alone.

Radiation dose for the combined exam is below FDA limits for mammography and below the dose of film mammography, according to the authors. Philpotts said her organization is doing both exams, but could switch to exclusively performing tomosynthesis in the future. “Researchers are working on ways to get a 2D image out of the 3D data, and when that happens, there may be no need for the 2D examination,” she said.

“Recalls from screening mammography incite considerable anxiety in women,” said Melissa Durand, MD, a study author. “With digital breast tomosynthesis, we are seeing a dramatic reduction in our recall rates which helps lessen our patients’ anxiety. Fewer recalls means fewer additional breast imaging views, which is cost saving and may also reduce overall annual radiation dose.”