Impact on the recall rate of digital breast tomosynthesis as an adjunct to digital mammography in the screening setting. A double reading experience and review of the literature

Luca A. Carbonaro, Giovanni Di Leo, Paola Clauser, Rubina M. Trimboli, Nicola Verardi, Maria P. Fedeli, Rossano Girometti, Alfredo Tafà, Paola Bruscoli, Gianni Saguatti, Massimo Bazzocchi, Francesco Sardanelli

Research output: Contribution to journalArticle

Abstract

Objectives To estimate the impact on recall rate (RR) of digital breast tomosynthesis (DBT) associated with digital mammography (DM + DBT), compared to DM alone, evaluate the impact of double reading (DR) and review the literature. Methods Ethics committees approved this multicenter study. Patients gave informed consent. Women recalled from population-based screening reading were included. Reference standard was histology and/or ≥1 year follow up. Negative multiple assessment was considered for patients lost at follow up. Two blinded readers (R1, R2) evaluated first DM and subsequently DM + DBT. RR, sensitivity, specificity, accuracy, positive and negative predictive values (PPV, NPV), were calculated for R1, R2, and DR. Cohen κ and χ2 were used for R1-R2 agreement and RR related to breast density. Results We included 280 cases (41 malignancies, 66 benign lesions, and 173 negative examinations). The RR reduction was 43% (R1), 58% (R2), 43% (DR). Sensitivity, specificity, accuracy, PPV and NPV were: 93%, 67%, 71%, 33%, 98% for R1; 88%, 73%, 75%, 36%, 97% for R2; 98%, 55%, 61%, 27%, 99% for DR. The agreement was higher for DM + DBT (κ=0.459 versus κ=0.234). Reduction in RR was independent from breast density (p = 0.992). Conclusion DBT was confirmed to reduce RR, as shown by 13 of 15 previous studies (reported reduction 6-82%, median 31%). This reduction is confirmed when using DR. DBT allows an increased inter-reader agreement.

Original languageEnglish
Pages (from-to)808-814
Number of pages7
JournalEuropean Journal of Radiology
Volume85
Issue number4
DOIs
Publication statusPublished - Apr 1 2016

Keywords

  • Breast cancer
  • Digital breast tomosynthesis (DBT)
  • Digital mammography (DM)
  • population based
  • Recall rate
  • Screening

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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