Tomosynthesis Better Detects Cancer in Dense Breasts

Digital tomosynthesis may be the key to better cancer detection in women with dense breasts, according to research presented last month during the annual meeting of the Radiological Society of North America.

Pertinent Points:

- Adding tomosynthesis to digital mammography improved cancer detection rates, especially among women with dense breasts, a new study found.

- Clinical outcomes were not studied, so it is unknown whether improved cancer detection rates correspond with better clinical outcomes.

Not only did researchers document improved screening with the 3D imaging in women with dense breasts, they also saw increased overall cancer detection rates across all breast density levels. The study focused on detection rates and not on clinical outcomes, so it was not known whether the increases in identifying cancers led to fewer deaths.

Still, the data was striking. When digital mammography plus tomosynthesis was used, researchers detected 80% of 132 cancers in women with dense breasts, compared with only 59% for mammography alone. Overall, across all breast densities, 82% of cancers were detected with the 3D mammography, versus 63% of cancers being detected using digital mammography alone.

In promoting their findings, the researchers suggested the marked improvements in detection are promising enough that using tomosynthesis could bring about a new era in breast cancer screening.

"Our findings are extremely promising, showing an overall relative increase in the cancer detection rate of about 30%," said lead study author Per Skaane, MD, PhD, from the Department of Radiology at Oslo University Hospital in Oslo, Norway. "Stratifying the results on invasive cancers only, the relative increase in cancer detection was about 40%."

The study included more than 25,000 women aged 50 to 69 years and compared the cancer detection rates using the traditional full-field digital mammography (FFDM) with adding digital tomosynthesis to FFDM. They relied on the BI-RADS breast density scale for determining breast density.