Breast Cancer Screening Using Tomosynthesis in Combination With Digital Mammography
Sarah M. Friedewald,Elizabeth A. Rafferty,Stephen L. Rose,Melissa A. Durand,Donna Plecha,Julianne S. Greenberg,Mary Katherine Hayes,Debra S. Copit,Kara L. Carlson,Thomas M. Cink,Lora D. Barke,Linda N. Greer,Dave P. Miller,Emily F. Conant +13 more
TLDR
Addition of tomosynthesis to digital mammography was associated with a decrease in recall rate and an increase in cancer detection rate, and further studies are needed to assess the relationship to clinical outcomes.Abstract:
mammography + tomosynthesis; difference, 1.3 (95% CI, 0.4-2.1; P = .004); for cancer detection, 4.2 (95% CI, 3.8-4.7) with digital mammography vs 5.4 (95% CI, 4.9-6.0) with digital mammography + tomosynthesis; difference, 1.2 (95% CI, 0.8-1.6; P < .001); and for invasive cancer detection, 2.9 (95% CI, 2.5-3.2) with digital mammography vs 4.1 (95% CI, 3.7-4.5) with digital mammography + tomosynthesis; difference, 1.2 (95% CI, 0.8-1.6; P < .001). The in situ cancer detection rate was 1.4 (95% CI, 1.2-1.6) per 1000 screens with both methods. Adding tomosynthesis was associated with an increase in the positive predictive value for recall from 4.3% to 6.4% (difference, 2.1%; 95% CI, 1.7%-2.5%; P < .001) and for biopsy from 24.2% to 29.2% (difference, 5.0%; 95% CI, 3.0%-7.0%; P < .001). CONCLUSIONS AND RELEVANCE Addition of tomosynthesis to digital mammography was associated with a decrease in recall rate and an increase in cancer detection rate. Further studies are needed to assess the relationship to clinical outcomes.read more
Citations
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Screening Mammography: Guidelines versus Clinical Practice
TL;DR: A disparity in screening practices by clinicians in all levels of training, particularly for patients ages 40–49 and 75+ , and for the interval of screening, was showed.
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Santo Maimone,A. Morozov,Haley Letter,Kristin A. Robinson,Margaret Wasserman,Zhuo Li,Robert W. Maxwell +6 more
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Management of a Woman at Elevated Risk for Breast Cancer
TL;DR: The identification and management of the high-risk patient, focusing on salient genetic and nongenetic risk factors, available options for risk management, and recommendations for risk modification for all women is discussed in this paper.
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The Impact of Acquisition Dose on Quantitative Breast Density Estimation with Digital Mammography: Results from ACRIN PA 4006.
Lin Chen,Shonket Ray,Brad M. Keller,Said Pertuz,Elizabeth S. McDonald,Emily F. Conant,Despina Kontos +6 more
TL;DR: Precision and reproducibility of automated breast density measurements with digital mammography are not substantially affected by variations in radiation dose; thus, the use of low-dose techniques for the purpose of density estimation may be feasible.
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Patient-Friendly Summary of the ACR Appropriateness Criteria® Supplemental Breast Cancer Screening Based on Breast Density.
Les James Feldman,Kemi Babagbemi +1 more
TL;DR: Procedure Appropriateness Category Relative Radiation Level Digital breast tomosynthesis screening Usually Appropriate ☢☢ Mammography with IV contrast Usually not Appropriate☢ US breast Usually Not Appropriate O MRI breast without and with IV Contrast Usually Not appropriating O MRI breasts without and without IV contrast abbreviated UsuallyNot Appropriate.
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TL;DR: The USPSTF concludes that the current evidence is insufficient to assess additional benefits and harms of either digital mammography or magnetic resonance imaging instead of film mammography as screening modalities for breast cancer.
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