Digital breast tomosynthesis for breast cancer screening and diagnosis in women with dense breasts - a systematic review and meta-analysis

Xuan Anh Phi, Alberto Tagliafico, Nehmat Houssami, Marcel J.W. Greuter, Geertruida H. de Bock

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: This study aimed to systematically review and to meta-analyse the accuracy of digital breast tomosynthesis (DBT) versus digital mammography (DM) in women with mammographically dense breasts in screening and diagnosis. Methods: Two independent reviewers identified screening or diagnostic studies reporting at least one of four outcomes (cancer detection rate-CDR, recall rate, sensitivity and specificity) for DBT and DM in women with mammographically dense breasts. Study quality was assessed using QUADAS-2. Meta-analysis of CDR and recall rate used a random effects model. Summary ROC curve summarized sensitivity and specificity. Results: Sixteen studies were included (five diagnostic; eleven screening). In diagnosis, DBT increased sensitivity (84%-90%) versus DM alone (69%-86%) but not specificity. DBT improved CDR versus DM alone (RR: 1.16, 95% CI 1.02-1.31). In screening, DBT + DM increased CDR versus DM alone (RR: 1.33, 95% CI 1.20-1.47 for retrospective studies; RR: 1.52, 95% CI 1.08-2.11 for prospective studies). Recall rate was significantly reduced by DBT + DM in retrospective studies (RR: 0.72, 95% CI 0.64-0.80) but not in two prospective studies (RR: 1.12, 95% CI 0.76-1.63). Conclusion: In women with mammographically dense breasts, DBT+/-DM increased CDR significantly (versus DM) in screening and diagnosis. In diagnosis, DBT+/-DM increased sensitivity but not specificity. The effect of DBT + DM on recall rate in screening dense breasts varied between studies.

Original languageEnglish
Article number380
JournalBMC Cancer
Volume18
Issue number1
DOIs
Publication statusPublished - Apr 3 2018

Fingerprint

Mammography
Early Detection of Cancer
Meta-Analysis
Breast
Breast Neoplasms
Sensitivity and Specificity
Retrospective Studies
Prospective Studies

Keywords

  • Breast density
  • Breast neoplasm
  • Digital breast tomosynthesis
  • Digital mammography
  • Meta-analysis
  • Review

ASJC Scopus subject areas

  • Oncology
  • Genetics
  • Cancer Research

Cite this

Digital breast tomosynthesis for breast cancer screening and diagnosis in women with dense breasts - a systematic review and meta-analysis. / Phi, Xuan Anh; Tagliafico, Alberto; Houssami, Nehmat; Greuter, Marcel J.W.; de Bock, Geertruida H.

In: BMC Cancer, Vol. 18, No. 1, 380, 03.04.2018.

Research output: Contribution to journalArticle

@article{458f0c7727434558a943c0dd39ac7768,
title = "Digital breast tomosynthesis for breast cancer screening and diagnosis in women with dense breasts - a systematic review and meta-analysis",
abstract = "Background: This study aimed to systematically review and to meta-analyse the accuracy of digital breast tomosynthesis (DBT) versus digital mammography (DM) in women with mammographically dense breasts in screening and diagnosis. Methods: Two independent reviewers identified screening or diagnostic studies reporting at least one of four outcomes (cancer detection rate-CDR, recall rate, sensitivity and specificity) for DBT and DM in women with mammographically dense breasts. Study quality was assessed using QUADAS-2. Meta-analysis of CDR and recall rate used a random effects model. Summary ROC curve summarized sensitivity and specificity. Results: Sixteen studies were included (five diagnostic; eleven screening). In diagnosis, DBT increased sensitivity (84{\%}-90{\%}) versus DM alone (69{\%}-86{\%}) but not specificity. DBT improved CDR versus DM alone (RR: 1.16, 95{\%} CI 1.02-1.31). In screening, DBT + DM increased CDR versus DM alone (RR: 1.33, 95{\%} CI 1.20-1.47 for retrospective studies; RR: 1.52, 95{\%} CI 1.08-2.11 for prospective studies). Recall rate was significantly reduced by DBT + DM in retrospective studies (RR: 0.72, 95{\%} CI 0.64-0.80) but not in two prospective studies (RR: 1.12, 95{\%} CI 0.76-1.63). Conclusion: In women with mammographically dense breasts, DBT+/-DM increased CDR significantly (versus DM) in screening and diagnosis. In diagnosis, DBT+/-DM increased sensitivity but not specificity. The effect of DBT + DM on recall rate in screening dense breasts varied between studies.",
keywords = "Breast density, Breast neoplasm, Digital breast tomosynthesis, Digital mammography, Meta-analysis, Review",
author = "Phi, {Xuan Anh} and Alberto Tagliafico and Nehmat Houssami and Greuter, {Marcel J.W.} and {de Bock}, {Geertruida H.}",
year = "2018",
month = "4",
day = "3",
doi = "10.1186/s12885-018-4263-3",
language = "English",
volume = "18",
journal = "BMC Cancer",
issn = "1471-2407",
publisher = "BioMed Central Ltd.",
number = "1",

}

TY - JOUR

T1 - Digital breast tomosynthesis for breast cancer screening and diagnosis in women with dense breasts - a systematic review and meta-analysis

AU - Phi, Xuan Anh

AU - Tagliafico, Alberto

AU - Houssami, Nehmat

AU - Greuter, Marcel J.W.

AU - de Bock, Geertruida H.

PY - 2018/4/3

Y1 - 2018/4/3

N2 - Background: This study aimed to systematically review and to meta-analyse the accuracy of digital breast tomosynthesis (DBT) versus digital mammography (DM) in women with mammographically dense breasts in screening and diagnosis. Methods: Two independent reviewers identified screening or diagnostic studies reporting at least one of four outcomes (cancer detection rate-CDR, recall rate, sensitivity and specificity) for DBT and DM in women with mammographically dense breasts. Study quality was assessed using QUADAS-2. Meta-analysis of CDR and recall rate used a random effects model. Summary ROC curve summarized sensitivity and specificity. Results: Sixteen studies were included (five diagnostic; eleven screening). In diagnosis, DBT increased sensitivity (84%-90%) versus DM alone (69%-86%) but not specificity. DBT improved CDR versus DM alone (RR: 1.16, 95% CI 1.02-1.31). In screening, DBT + DM increased CDR versus DM alone (RR: 1.33, 95% CI 1.20-1.47 for retrospective studies; RR: 1.52, 95% CI 1.08-2.11 for prospective studies). Recall rate was significantly reduced by DBT + DM in retrospective studies (RR: 0.72, 95% CI 0.64-0.80) but not in two prospective studies (RR: 1.12, 95% CI 0.76-1.63). Conclusion: In women with mammographically dense breasts, DBT+/-DM increased CDR significantly (versus DM) in screening and diagnosis. In diagnosis, DBT+/-DM increased sensitivity but not specificity. The effect of DBT + DM on recall rate in screening dense breasts varied between studies.

AB - Background: This study aimed to systematically review and to meta-analyse the accuracy of digital breast tomosynthesis (DBT) versus digital mammography (DM) in women with mammographically dense breasts in screening and diagnosis. Methods: Two independent reviewers identified screening or diagnostic studies reporting at least one of four outcomes (cancer detection rate-CDR, recall rate, sensitivity and specificity) for DBT and DM in women with mammographically dense breasts. Study quality was assessed using QUADAS-2. Meta-analysis of CDR and recall rate used a random effects model. Summary ROC curve summarized sensitivity and specificity. Results: Sixteen studies were included (five diagnostic; eleven screening). In diagnosis, DBT increased sensitivity (84%-90%) versus DM alone (69%-86%) but not specificity. DBT improved CDR versus DM alone (RR: 1.16, 95% CI 1.02-1.31). In screening, DBT + DM increased CDR versus DM alone (RR: 1.33, 95% CI 1.20-1.47 for retrospective studies; RR: 1.52, 95% CI 1.08-2.11 for prospective studies). Recall rate was significantly reduced by DBT + DM in retrospective studies (RR: 0.72, 95% CI 0.64-0.80) but not in two prospective studies (RR: 1.12, 95% CI 0.76-1.63). Conclusion: In women with mammographically dense breasts, DBT+/-DM increased CDR significantly (versus DM) in screening and diagnosis. In diagnosis, DBT+/-DM increased sensitivity but not specificity. The effect of DBT + DM on recall rate in screening dense breasts varied between studies.

KW - Breast density

KW - Breast neoplasm

KW - Digital breast tomosynthesis

KW - Digital mammography

KW - Meta-analysis

KW - Review

UR - http://www.scopus.com/inward/record.url?scp=85044851036&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85044851036&partnerID=8YFLogxK

U2 - 10.1186/s12885-018-4263-3

DO - 10.1186/s12885-018-4263-3

M3 - Article

AN - SCOPUS:85044851036

VL - 18

JO - BMC Cancer

JF - BMC Cancer

SN - 1471-2407

IS - 1

M1 - 380

ER -