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Invited Commentary
February 28, 2019

Breast Cancer Screening Using Digital Breast Tomosynthesis: Not All Mammography Is Equal

Author Affiliations
  • 1Department of Radiology, Massachusetts General Hospital, Boston
JAMA Oncol. 2019;5(5):642-643. doi:10.1001/jamaoncol.2018.7056

Digital breast tomosynthesis (DBT), a form of mammography approved by the US Food and Drug Administration in 2011, involves the acquisition of projection images that are reconstructed into thin sections of the breast. Despite emerging evidence that use of DBT improves cancer detection and reduces false-positive examination results when compared with 2-dimensional digital mammography (DM), questions remain regarding its performance across different patient subgroups, the size and stage of the cancers detected, and long-term patient outcomes. In this issue of JAMA Oncology, Conant and colleagues1 report outcomes of breast cancer screening using DBT vs DM among 96 269 women aged 40 to 74 years across 3 research centers in the Population-Based Research Optimizing Screening Through Personalized Regimens (PROSPR) consortium. Based on data from 50 971 screening examinations using DBT and 129 369 screening examinations using DM, the authors conclude that DBT screening was associated with higher cancer detection rates and lower recall rates across all ages and density groups. In addition, the authors report that DBT-detected cancers were more likely to be smaller and node negative than were DM-detected cancers, particularly among women aged 40 to 49 years.

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