Introduction of one-view tomosynthesis in population-based mammography screening: Impact on detection rate, interval cancer rate and false-positive rate

Bolette Mikela Vilmun*, George Napolitano, Martin Lillholm, Rikke Rass Winkel, Elsebeth Lynge, Mads Nielsen, Michael Bachmann Nielsen, Jonathan Frederik Carlsen, My von Euler-Chelpin, Ilse Vejborg

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Abstract

Objective
To assess performance endpoints of a combination of digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) compared with FFDM only in breast cancer screening.
Materials and methods
This was a prospective population-based screening study, including eligible (50–69 years) women attending the Capital Region Mammography Screening Program in Denmark. All attending women were offered FFDM. A subgroup was consecutively allocated to a screening room with DBT. All FFDM and DBT underwent independent double reading, and all women were followed up for 2 years after screening date or until next screening date, whichever came first.
Results
6353 DBT + FFDM and 395 835 FFDM were included in the analysis and were undertaken in 196 267 women in the period from 1 November 2012 to 12 December 2018. Addition of DBT increased sensitivity: 89.9% (95% confidence interval (CI): 81.0–95.5) for DBT + FFDM and 70.1% (95% CI: 68.6–71.6) for FFDM only, p < 0.001. Specificity remained similar: 98.2% (95% CI: 97.9–98.5) for DBT + FFDM and 98.3% (95% CI: 98.2–98.3) for FFDM only, p = 0.9. Screen-detected cancer rate increased statistically significantly: 11.18/1000 for DBT + FFDM and 6.49/1000 for FFDM only, p < 0.001. False-positive rate was unchanged: 1.75% for DBT + FFDM and 1.73% for FFDM only, p = 0.9. Positive predictive value for recall was 39.0% (95% CI: 31.9–46.5) for DBT + FFDM and 27.3% (95% CI: 26.4–28.2), for FFDM only, p < 0.0005. The interval cancer rate decreased: 1.26/1000 for DBT + FFDM and 2.76/1000 for FFDM only, p = 0.02.
Conclusion
DBT + FFDM yielded a statistically significant increase in cancer detection and program sensitivity.
OriginalsprogEngelsk
TidsskriftJournal of Medical Screening
ISSN0969-1413
DOI
StatusAccepteret/In press - 2024

Bibliografisk note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was part of a work supported by Eurostars [5091 \u2013 00036B]. They have not been involved in the design of the study, collection, analysis, interpretation of data, writing the manuscript or in the decision to publish the results.

Publisher Copyright:
© The Author(s) 2024.

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