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Comment & Response
June 2019

Digital Breast Tomosynthesis for Women Older Than 70 Years

Author Affiliations
  • 1Yale School of Medicine, New Haven, Connecticut
JAMA Intern Med. 2019;179(6):853. doi:10.1001/jamainternmed.2019.1234

To the Editor In a Viewpoint article, Richman and Gross1 discussed the use of new breast cancer screening technologies in older women. Citing a study by Sharpe et al,2 they state “we are aware of only 1 study of digital breast tomosynthesis that has reported outcomes in women older than 70 years.”1 There have, however, been several studies on the use of digital breast tomosynthesis in older women. In the cited study,2 only 923 patients 70 years or older from 1 institution were screened with digital breast tomosynthesis. Thus, it is not surprising that significant differences in recall rates between digital breast tomosynthesis and digital mammography were not seen. Moreover, the study by Sharpe et al2 and cited by Richman and Gross1 has been criticized for errors in data analysis.3 For example, the authors excluded a cohort of about 9000 examinations read by lower-volume general radiologists from their analysis. However, cancer detection rate was calculated including this lower-volume cohort.

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