title: A reader study comparing prospective tomosynthesis interpretations with retrospective readings of the corresponding FFDM examinations.
abstract: OBJECTIVE
  To compare performance of prospective interpretations of clinical tomosynthesis (digital breast tomosynthesis [DBT]) plus full-field digital mammography (FFDM) examinations with retrospective readings of the corresponding FFDM examinations alone.
  
  
  METHODS
  Seven Mammography Quality Standard Act-qualified radiologists retrospectively interpreted 10,878 FFDM examinations that had been interpreted by other radiologists during prospective clinical interpretations of DBT plus FFDM. The radiologists were blinded to the Breast Imaging Reporting and Data System (BIRADS) category given during the clinical interpretations and the verified outcome by follow-up and/or any diagnostic workup that may have followed. Ratings (BIRADS 0, 1, or 2) were recorded. Group performance levels in terms of recall rates and attributable cancer detection rates were compared to the prospective clinical interpretations of the same examinations (DBT plus FFDM) using McNemar test (two sided/tailed) with significance level of .05.
  
  
  RESULTS
  During the prospective clinical interpretations of DBT plus FFDM, 588 cases were recalled (588 of 10,878, 5.41%) compared to 888 cases recalled (888 of 10,878, 8.16%) during the FFDM-alone retrospective interpretations (absolute difference, 35%; P<.0001). There were 59 and 38 suspicious abnormalities later verified as cancers detected during the DBT plus FFDM and the FFDM-alone interpretations, respectively (absolute increase, 55%; P<.0001). Invasive cancer detections were 48 and 29, respectively (absolute increase, 66%; P<.0001).
  
  
  CONCLUSIONS
  The combination of DBT plus FFDM for screening asymptomatic women resulted in a significant reduction in recall rates and a simultaneous increase in cancer detection rates when compared to retrospective interpretations of corresponding FFDM examinations alone.
authors.affiliation: TOPS Comprehensive Breast Center, 17030 Red Oak Dr, Houston, TX 77090. Electronic address: slrosemd@hbimaging.onmicrosoft.com.
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Rose
authors.affiliation: TOPS Comprehensive Breast Center, 17030 Red Oak Dr, Houston, TX 77090.
authors.forename: Andra L
authors.initials: AL
authors.lastname: Tidwell
authors.affiliation: TOPS Comprehensive Breast Center, 17030 Red Oak Dr, Houston, TX 77090.
authors.forename: Mary F
authors.initials: MF
authors.lastname: Ice
authors.affiliation: TOPS Comprehensive Breast Center, 17030 Red Oak Dr, Houston, TX 77090.
authors.forename: Amy S
authors.initials: AS
authors.lastname: Nordmann
authors.affiliation: TOPS Comprehensive Breast Center, 17030 Red Oak Dr, Houston, TX 77090.
authors.forename: Russell
authors.initials: R
authors.lastname: Sexton
authors.affiliation: TOPS Comprehensive Breast Center, 17030 Red Oak Dr, Houston, TX 77090.
authors.forename: Rui
authors.initials: R
authors.lastname: Song
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Breast cancer; cancer detection rates; recall rates; screening; tomosynthesis (DBT)