New study supports effectiveness of 3-D breast cancer mammography

Print 04 December 2014
Joseph Keenan, FeirceMedicalDevices

Using digital mammography with tomosynthesis improves detection of cancer in dense breasts

A new study supports the effectiveness of 3-D mammography, which researchers found has the potential to significantly increase the rate of identifying cancer in women with dense breasts who are screened using the digital technology.

Using digital mammography along with tomosynthesis, which provides a 3-D view, researchers detected 80% of the 132 cancers in women with dense breasts, compared to 59% detection when using mammography alone. The study, which included more than 25,000 women, was presented Tuesday in Chicago at a meeting of the Radiological Society of North America.

Breasts that are fibrous or have a lot of glandular tissue but little fatty tissue are considered dense, and are most likely to develop cancer, the researchers said in a press release. Because of the density, cancer can be difficult to detect using traditional mammograms.

Other imaging systems, like ultrasounds and MRIs, are used to detect breast cancer that can't be seen on mammograms, but they have higher rates of false-positive findings that turn out not to be cancer. Such false-positive results trigger unnecessary biopsies and also increase the costs to patients, medical institutions and insurers, the researchers said.

"Tomosynthesis could be regarded as an improvement of mammography and would be much easier than MRI or ultrasound to implement in organized screening programs," Per Skaane, lead author of the study and an M.D. and Ph.D. from Oslo University Hospital in Norway, said in a statement. "So the intention of our study was to see if tomosynthesis really would significantly increase the cancer detection rate in a population-based mammography screening program."

In the study, 257 malignancies were detected using full-field digital mammography (FFDM) and a combination of FFDM and tomosynthesis. Of the 257 cancers, 211, or 82%, were detected with FFDM plus tomosynthesis, a significant improvement over the 163, or 63%, detected with FFDM alone.

"Our findings are extremely promising, showing an overall relative increase in the cancer detection rate of about 30%," Skaane said. "Stratifying the results on invasive cancers only, the relative increase in cancer detection was about 40%."

Not only did the use of tomosynthesis increase the rate of cancer detection in women with dense breasts, it also helped improve detection for women in the "fatty breast" category. The combination of tomosynthesis with FFDM bumped the cancer detection rate up to 84% from 68%.

3-D breast cancer imaging was first approved by the FDA in 2011. In a study published by JAMA in June, researchers using data compiled from 13 U.S. hospitals found that when using 3-D imaging, 16 fewer women out of 1,000 tested had to undergo more screening compared to those receiving traditional imaging.

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