Breast cancer screening using tomosynthesis in combination with digital mammography compared to digital mammography alone: a cohort study within the PROSPR consortium

被引:153
作者
Conant, Emily F. [1 ]
Beaber, Elisabeth F. [2 ]
Sprague, Brian L. [3 ,4 ]
Herschorn, Sally D. [4 ,5 ]
Weaver, Donald L. [4 ,6 ]
Onega, Tracy [7 ,8 ,9 ]
Tosteson, Anna N. A. [7 ,8 ,9 ]
McCarthy, Anne Marie [10 ]
Poplack, Steven P. [11 ]
Haas, Jennifer S. [12 ]
Armstrong, Katrina [10 ]
Schnall, Mitchell D. [1 ]
Barlow, William E. [13 ]
机构
[1] Univ Penn, Perelman Sch Med, Dept Radiol, 3400 Spruce St, Philadelphia, PA 19104 USA
[2] Fred Hutchinson Canc Res Ctr, Div Publ Hlth Sci, 1124 Columbia St, Seattle, WA 98104 USA
[3] Univ Vermont, Dept Surg, Burlington, VT 05405 USA
[4] Univ Vermont, Ctr Canc, Burlington, VT USA
[5] Univ Vermont, Dept Radiol, Burlington, VT USA
[6] Univ Vermont, Dept Pathol, Burlington, VT 05405 USA
[7] Geisel Sch Med Dartmouth, Dept Community & Family Med, Lebanon, NH USA
[8] Geisel Sch Med Dartmouth, Dartmouth Inst Hlth Policy & Clin Practice, Lebanon, NH USA
[9] Geisel Sch Med Dartmouth, Norris Cotton Canc Ctr, Lebanon, NH USA
[10] Massachusetts Gen Hosp, Dept Med, Boston, MA 02114 USA
[11] Washington Univ, Mallinckrodt Inst Radiol, St Louis, MO USA
[12] Brigham & Womens Hosp, Div Gen Internal Med & Primary Care, 75 Francis St, Boston, MA 02115 USA
[13] Canc Res & Biostat, Seattle, WA USA
关键词
Breast cancer screening; Mammography; Digital breast tomosynthesis;
D O I
10.1007/s10549-016-3695-1
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Digital breast tomosynthesis (DBT) is emerging as the new standard of care for breast cancer screening based on improved cancer detection coupled with reductions in recall compared to screening with digital mammography (DM) alone. However, many prior studies lack follow-up data to assess false negatives examinations. The purpose of this study is to assess if DBT is associated with improved screening outcomes based on follow-up data from tumor registries or pathology. Retrospective analysis of prospective cohort data from three research centers performing DBT screening in the PROSPR consortium from 2011 to 2014 was performed. Recall and biopsy rates were assessed from 198,881 women age 40-74 years undergoing screening (142,883 DM and 55,998 DBT examinations). Cancer, cancer detection, and false negative rates and positive predictive values were assessed on examinations with one year of follow-up. Logistic regression was used to compare DBT to DM adjusting for research center, age, prior breast imaging, and breast density. There was a reduction in recall with DBT compared to DM (8.7 vs. 10.4 %, p < 0.0001), with adjusted OR = 0.68 (95 % CI = 0.65-0.71). DBT demonstrated a statistically significant increase in cancer detection over DM (5.9 vs. 4.4/1000 screened, adjusted OR = 1.45, 95 % CI = 1.12-1.88), an improvement in PPV1 (6.4 % for DBT vs. 4.1 % for DM, adjusted OR = 2.02, 95 % CI = 1.54-2.65), and no significant difference in false negative rates for DBT compared to DM (0.46 vs. 0.60/1000 screened, p = 0.347). Our data support implementation of DBT screening based on increased cancer detection, reduced recall, and no difference in false negative screening examinations.
引用
收藏
页码:109 / 116
页数:8
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