Tomosynthesis Disadvantages

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DBT practice patterns begin to emerge “Currently, according to the FDA’s MQSA [Mammography Quality Standards Act] website, more than one-third of facilities that perform mammography in the U. A total of 59% of those using DBT include synthetic 2D mammography; only 24% use synthetic 2D technology alone.

The authors stress the need for “consensus and standardization” as DBT is integrated globally across all practice types. Holt says, “showing advantages as the potential new standard of breast cancer screening in the U. as older machines increasingly are being replaced with newer models capable of tomosynthesis.” Dr.

Significant decreases in recall rates were apparent in all age groups, with the largest reduction occurring for women 40 to 49 years of age (model-adjusted recalls per 1000 screens: 137 with DM versus 115 with DM plus DBT).

“The magnitude of performance gains was greatest for women ages 40 to 49 and argues strongly for tomosynthesis screening for breast cancer detection as the standard of care for women beginning at the age of 40,” the researchers concluded.

Radiologists have been challenged by the ever-changing recommendations of when breast cancer screening should begin and the frequency of screening, says Sarah M.

Friedewald, MD, division chief, Breast and Women’s Imaging, and medical director, Lynn Sage Comprehensive Breast Cancer Center, Northwestern Memorial Hospital.One study in particular, by Rafferty and colleagues, investigated the effect of age on breast cancer detection when DBT is used in combination with DM.Screening performance measures from 13 institutions were compared and analyzed by age group among 278,908 women who were screened with DM alone and 173,414 who underwent screening with DM plus DBT. The addition of DBT to DM significantly increased the invasive cancer detection rate for women 40 to 69 years of age, with rates increasing from 1.6% to 2.7% for women in the 40 to 49 age group.Graham Cancer Center and Research Institute, in Newark, Del.Combining DBT with conventional 2D mammography leads to decreases in false positives and, consequently, lessens the need for additional imaging, office visits, and other downstream costs, Dr. “Perhaps more important are the intangible savings to the patient, such as less time off from work and less anxiety.” These benefits, she says, are particularly relevant in this era of value-based care, in which population care, cost containment, and patient satisfaction are paramount.The controversy surrounding screening recommendations can be a distraction to the implementation of new technologies, such as tomosynthesis, a screening process that renders 3D-like images of the breast.It’s one of the biggest improvements to come along since digital imaging, and for good reason, Friedewald told an audience during a presentation at the 2016 Lynn Sage Breast Cancer Symposium.The number of images a tomosynthesis machine takes is based on the individual manufacturer recommendations, explained Friedewald, and not a radiologist’s decision.“For example, if a breast has a 5% compression, the tomosynthesis scan might result in 54 images; but not to be confused, there’s not 54 images of the breast taken for us to look at.” Tomosynthesis received FDA approval in 2011. As a multitude of published studies suggest, the addition of tomosynthesis to DM significantly lowers recall rates and improves cancer detection, says Jacqueline Holt, MD, Director of Breast Imaging at the Helen F. Food and Drug Administration (FDA) in 2011, this imaging technology, also referred to as 3D mammography, has been increasingly integrated into clinical practice across the U. and around the world as an adjunct to standard 2-view digital screening mammography (DM).


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