How can you reduce your data volume in breast cancer screening?

20-11-2017

Using 2-view Digital Breast Tomosynthesis (DBT) as a stand-alone modality can help reduce the fast growing data volume in breast cancer screening. Although DBT provides more detail than a mammogram and can increase the cancer detection rate, there are still clinical and traditional arguments for retaining digital mammography with DBT. Reasons include that mammography images enable easy comparison with prior exams and give an overview of the whole breast. Further, reimbursement regulations may require that a 2D image is acquired together with DBT.

So far, the USA is the only country that has approved 2-view DBT to be used as a stand-alone modality in breast cancer screening for one mammography system.1 For the FDA, there was sufficient evidence that DBT offers:

  • superior diagnostic accuracy,
  • a reduced non-cancer recall rate,
  • improved reader performance, and
  • lower interobserver variability.

All of these improvements are highly relevant to the clinical implementation and are strong drivers for DBT to become the standard of care in screening and diagnostic mammography. What’s more, using 2-view DBT as stand-alone also eliminates the additional radiation dose needed for mammography. 

Would 1-view DBT be sufficient?

But even the use of 2-view DBT alone still produces a great amount of data. So the question is if 1-view DBT would be clinically sufficient for confident and reliable breast cancer screening. After all, it also provides a 3D volume of the breast. Or is a second tomo view of the breast required as it is in 2D mammography?


The Malmö Breast Tomosynthesis Screening Trial (MBTST) has shown that (in screening) 1-view DBT alone can suffice. Comparing 1-view DBT to 2-view digital mammography, their results proved:
 

The conclusion of their study is that 1-view DBT might be feasible as a stand-alone screening modality.2


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İlgili makaleler

1Please find the Premarket Approval (PMA) for the Mammomat Inspiration With Tomosynthesis Option and the corresponding PMA Study directly on the FDA page:
https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P140011S003

2Please find a press release as well as a video and the full study on the Lund University homepage:
http://www.lunduniversity.lu.se/article/watch-new-method-detects-more-breast-cancer-in-screening

Lång et al. Performance of one-view breast tomosynthesis as a stand-alone breast cancer screening modality: results
from the Malmö Breast Tomosynthesis Screening Trial, a population-based study Eur Radiol (2015)