Pairing DBT with synthetic mammography beats traditional ‘one size fits all’ breast screening approach

Combining digital breast tomosynthesis with synthetic mammography boosts radiologists’ cancer detection capabilities compared to using digital mammography alone, new research published Tuesday demonstrated.

Many breast cancer screening programs successfully rely on mammography to catch the disease early, before it spreads and becomes harder to treat. But the modality also comes with limitations, including higher recall rates that force some women to undergo additional imaging exams, Italian researches explained in Radiology.

After looking over results from more than 32,000 women who were screened and then rescreened two years later, DBT combined with SM detected a higher percentage of early-stage cases and more cancers overall.

“The lower number of stage II or above cancers with the DBT plus synthetic mammography screening test demonstrates that DBT has the capability of anticipating the detection of cancers that might become advanced in the following two years,” Francesca Caumo, MD, with the Veneto Institute of Oncology’s breast imaging department in Italy, said in a statement. “This gives a higher benefit to our patients.”

For their study, the team analyzed exam results from 32,870 women—58 years old, on average—who were screened and then rescreened for breast cancer. Their first round included DBT and synthetic mammography, with the participants then split about evenly to receive a subsequent exam using DBT-SM or mammography.

During patients’ second exams, DBT and synthetic mammo detected more cancers, spotting 8.1 per 1,000 women screened compared to 4.5 per 1,000 for mammography. The authors found no difference in recall rate between the two options.

Going forward, the team will undertake an analysis of cancers that appear in the time between screening.

“The main goal of this research is to demonstrate that a personalized model of screening is more efficient than a normal one that I like to call a ‘one size fits all’ program, in which every woman must do an annual mammography screening test without any risk stratification,” Caumo added. “The risk category will determine the intervals of the subsequent screening event: biennial for low-risk women and annual for intermediate and high-risk women.”

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Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.

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