Digital Breast Tomosynthesis May Improve Cancer Detection

May be more accurate than mammography but with greater radiation exposure

FRIDAY, May 24 (HealthDay News) -- Digital breast tomosynthesis, which produces three-dimensional images of the breast, may be more accurate than mammography in detecting breast cancer but may also expose women to more radiation, according to a technology assessment published in the June issue of Obstetrics & Gynecology.

The Committee on Gynecologic Practice notes that conventional mammography imaging has a sensitivity of 77 to 95 percent and a specificity of 94 to 97 percent for detecting breast cancer. Magnetic resonance imaging has greater sensitivity but lower specificity. Digital mammography may be better able to detect breast cancers in women with dense breast tissue, according to the committee.

Digital breast tomosynthesis reconstructs individual images into a series of thin high-resolution slices and thus is able to image overlapping dense normal breast tissue. This may improve the accuracy of distinguishing benign and malignant lesions. Recent studies suggest that the addition of tomosynthesis may modestly increase breast cancer detection compared with mammography alone and reduce recall rates for women with false-positive test results. However, the committee notes that the mean glandular radiation dose is higher than a digital mammogram.

"Clinical data suggest that digital mammography with tomosynthesis produces a better image, improved accuracy, and lower recall rates compared with digital mammography alone," the authors write. "Further study will be necessary to confirm whether digital mammography with tomosynthesis is a cost-effective approach, capable of replacing digital mammography alone as the first-line screening modality of choice for breast cancer screening."

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