Performance of Digital Breast Tomosynthesis, Synthetic Mammography, and Digital Mammography in Breast Cancer Screening: A Systematic Review and Meta-Analysis

Overview

Journal J Natl Cancer Inst

Publisher Oxford University Press

Specialty Oncology

Date 2020 Dec 29

PMID 33372954

Citations 20

Authors

Mostafa Alabousi

Akshay Wadera

Mohammed Kashif Al-Ghita

Rayeh Kashef Al-Ghetaa

Jean-Paul Salameh

Alex Pozdnyakov

Nanxi Zha

Lucy Samoilov

Anahita Dehmoobad Sharifabadi

Behnam Sadeghirad

Vivianne Freitas

Matthew Df McInnes

Abdullah Alabousi

Affiliations

Soon will be listed here.

Abstract

Background: Our objective was to perform a systematic review and meta-analysis comparing the breast cancer detection rate (CDR), invasive CDR, recall rate, and positive predictive value 1 (PPV1) of digital mammography (DM) alone, combined digital breast tomosynthesis (DBT) and DM, combined DBT and synthetic 2-dimensional mammography (S2D), and DBT alone.

Methods: MEDLINE and Embase were searched until April 2020 to identify comparative design studies reporting on patients undergoing routine breast cancer screening. Random effects model proportional meta-analyses estimated CDR, invasive CDR, recall rate, and PPV1. Meta-regression modeling was used to compare imaging modalities. All statistical tests were 2-sided.

Results: Forty-two studies reporting on 2 606 296 patients (13 003 breast cancer cases) were included. CDR was highest in combined DBT and DM (6.36 per 1000 screened, 95% confidence interval [CI] = 5.62 to 7.14, P < .001), and combined DBT and S2D (7.40 per 1000 screened, 95% CI = 6.49 to 8.37, P < .001) compared with DM alone (4.68 per 1000 screened, 95% CI = 4.28 to 5.11). Invasive CDR was highest in combined DBT and DM (4.53 per 1000 screened, 95% CI = 3.97 to 5.12, P = .003) and combined DBT and S2D (5.68 per 1000 screened, 95% CI = 4.43 to 7.09, P < .001) compared with DM alone (3.42 per 1000 screened, 95% CI = 3.02 to 3.83). Recall rate was lowest in combined DBT and S2D (42.3 per 1000 screened, 95% CI = 37.4 to 60.4, P<.001). PPV1 was highest in combined DBT and DM (10.0%, 95% CI = 8.0% to 12.0%, P = .004), and combined DBT and S2D (16.0%, 95% CI = 10.0% to 23.0%, P < .001), whereas no difference was detected for DBT alone (7.0%, 95% CI = 6.0% to 8.0%, P = .75) compared with DM alone (7.0%, 95.0% CI = 5.0% to 8.0%).

Conclusions: Our findings provide evidence on key performance metrics for DM, DBT alone, combined DBT and DM, and combined DBT and S2D, which may inform optimal application of these modalities for breast cancer screening.

Citing Articles

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PMID: 39999963 PMC: 11865904. DOI: 10.3348/kjr.2024.0664.

Diagnostic performance of tomosynthesis plus synthetic mammography versus full-field digital mammography with or without tomosynthesis in breast cancer screening: A systematic review and meta-analysis.

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Duan X, Huang H, Zhao W J Med Imaging (Bellingham). 2024; 12(Suppl 1):S13002.

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Shen E, Li C, Zhao K, Yuan J, Carson P J Imaging Inform Med. 2024; 37(5):2649-2661.

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