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Eur J Radiol. 2016 Apr;85(4):808-14. doi: 10.1016/j.ejrad.2016.01.004. Epub 2016 Jan 16.

Impact on the recall rate of digital breast tomosynthesis as an adjunct to digital mammography in the screening setting. A double reading experience and review of the literature.

Author information

1
Radiology Unit, Research Hospital Policlinico San Donato, San Donato Milanese, Milan, Italy.
2
Institute of Radiology, Department of Medical and Biological Sciences, University of Udine, Udine, Italy; Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Austria. Electronic address: clauser.p@hotmail.it.
3
Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Milan, Italy.
4
Institute of Radiology, Department of Medical and Biological Sciences, University of Udine, Udine, Italy.
5
Unità Operativa di Senologia, Ospedale Maggiore, AUSL Bologna, Bologna, Italy.
6
Radiology Unit, Research Hospital Policlinico San Donato, San Donato Milanese, Milan, Italy; Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy.

Abstract

OBJECTIVES:

To estimate the impact on recall rate (RR) of digital breast tomosynthesis (DBT) associated with digital mammography (DM+DBT), compared to DM alone, evaluate the impact of double reading (DR) and review the literature.

METHODS:

Ethics committees approved this multicenter study. Patients gave informed consent. Women recalled from population-based screening reading were included. Reference standard was histology and/or ≥ 1 year follow up. Negative multiple assessment was considered for patients lost at follow up. Two blinded readers (R1, R2) evaluated first DM and subsequently DM+DBT. RR, sensitivity, specificity, accuracy, positive and negative predictive values (PPV, NPV), were calculated for R1, R2, and DR. Cohen κ and χ(2) were used for R1-R2 agreement and RR related to breast density.

RESULTS:

We included 280 cases (41 malignancies, 66 benign lesions, and 173 negative examinations). The RR reduction was 43% (R1), 58% (R2), 43% (DR). Sensitivity, specificity, accuracy, PPV and NPV were: 93%, 67%, 71%, 33%, 98% for R1; 88%, 73%, 75%, 36%, 97% for R2; 98%, 55%, 61%, 27%, 99% for DR. The agreement was higher for DM+DBT (κ=0.459 versus κ=0.234). Reduction in RR was independent from breast density (p=0.992).

CONCLUSION:

DBT was confirmed to reduce RR, as shown by 13 of 15 previous studies (reported reduction 6-82%, median 31%). This reduction is confirmed when using DR. DBT allows an increased inter-reader agreement.

KEYWORDS:

Breast cancer; Digital breast tomosynthesis (DBT); Digital mammography (DM); Recall rate; Screening; population based

PMID:
26971428
DOI:
10.1016/j.ejrad.2016.01.004
[Indexed for MEDLINE]

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