Breast Cancer Research and Treatment

, Volume 164, Issue 3, pp 557–569 | Cite as

Benefit of adding digital breast tomosynthesis to digital mammography for breast cancer screening focused on cancer characteristics: a meta-analysis

  • Seong Jong Yun
  • Chang-Woo Ryu
  • Sun Jung Rhee
  • Jung Kyu Ryu
  • Ji Young Oh



We evaluated the benefit of adding digital breast tomosynthesis (DBT) to full-field digital mammography (FFDM) compared to FFDM alone for breast cancer detection, focusing on cancer characteristics.


We searched electronic databases and relevant references for published studies comparing DBT plus FFDM to FFDM alone for breast cancer screening. Pooled risk ratios (RRs) for various pathologic findings were determined using random effects models.


Eleven eligible studies were included. Pooled RRs showed a greater cancer detection for DBT plus FFDM than for FFDM alone for invasive cancer (1.327; 95% CI, 1.168–1.508), stage T1 (1.388; 95% CI, 1.137–1.695), nodal-negative (1.451; 95% CI, 1.209–1.742), all histologic grades (grade I, 1.812; grade II/III, 1.403), and histologic types of invasive cancer (ductal, 1.437; lobular, 1.901). However, adding DBT did not increase for detection of carcinoma in situ (1.198; 95% CI, 0.942–1.524), stage ≥T2 (1.391; 95% CI, 0.895–2.163), or nodal-positive cancer (1.336; 95% CI, 0.921–1.938). Heterogeneity among studies was not significant in any subset analysis.


Adding DBT to FFDM enabled detection of early invasive breast cancer that might have been missed with FFDM alone. Knowing which cancer characteristic DBT detects may allow it to play a complementary role in predicting long-term patient outcomes and facilitate treatment planning.


Breast neoplasms Early detection of cancer Digital breast tomosynthesis Mammography Meta-analysis Preventive health services 



Confidence interval


Digital breast tomosynthesis


Carcinoma in situ


Digital mammography


Full-field digital mammography


Invasive ductal cancer


Invasive lobular cancer


Malmö Breast Tomosynthesis Screening Trial


Oslo Tomosynthesis Screening Trial


Quality assessment of diagnostic accuracy studies-2


Risk ratio


Screening with tomosynthesis OR standard mammography



This work was supported by a grant from Kyung Hee University in 2016 (KHU-20160695).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Role of funding source

The sponsors had no role in the design of the meta-analysis; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the work for publication. The researchers performed this work independently of the funding sources.

Statement of human and animal rights

This article does not contain any studies with human participants performed by any of the authors.

Supplementary material

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Supplementary material 1 (DOC 56 kb)
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Supplementary material 2 (TIFF 274 kb)
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Supplementary material 3 (TIFF 291 kb)
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Supplementary material 4 (TIFF 282 kb)


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Department of Medicine, Graduate SchoolKyung Hee UniversitySeoulRepublic of Korea
  2. 2.Department of RadiologyKyung Hee University Hospital at Gangdong, Kyung Hee University School of MedicineSeoulRepublic of Korea

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