Benefit of adding digital breast tomosynthesis to digital mammography for breast cancer screening focused on cancer characteristics: a meta-analysis
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.
KeywordsBreast neoplasms Early detection of cancer Digital breast tomosynthesis Mammography Meta-analysis Preventive health services
Digital breast tomosynthesis
Carcinoma in situ
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
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.
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