Performance of one-view breast tomosynthesis as a stand-alone breast cancer screening modality: results from the Malmö Breast Tomosynthesis Screening Trial, a population-based study.
OBJECTIVE
To assess the performance of one-view digital breast tomosynthesis (DBT) in breast cancer screening.


METHODS
The Malmö Breast Tomosynthesis Screening Trial is a prospective population-based one-arm study with a planned inclusion of 15000 participants; a random sample of women aged 40-74 years eligible for the screening programme. This is an explorative analysis of the first half of the study population (n = 7500). Participants underwent one-view DBT and two-view digital mammography (DM), with independent double reading and scoring. Primary outcome measures were detection rate, recall rate and positive predictive value (PPV). McNemar's test with 95 % confidence intervals was used.


RESULTS
Breast cancer was found in sixty-eight women. Of these, 46 cases were detected by both modalities, 21 by DBT alone and one by DM alone. The detection rate for one-view DBT was 8.9/1000 screens (95 % CI 6.9 to 11.3) and 6.3/1000 screens (4.6 to 8.3) for two-view DM (p < 0.0001). The recall rate after arbitration was 3.8 % (3.3 to 4.2) for DBT and 2.6 % (2.3 to 3.0) for DM (p < 0.0001). The PPV was 24 % for both DBT and DM.


CONCLUSIONS
Our results suggest that one-view DBT might be feasible as a stand-alone screening modality.


CONCLUSIONS
One-view DBT as a stand-alone breast cancer screening modality has not been investigated. One-view DBT increased the cancer detection rate significantly. The recall rate increased significantly but was still low. Breast cancer screening with one-view DBT as a stand-alone modality seems feasible.
Department of Diagnostic Radiology, Translational Medicine Malmö, Lund University, Inga Marie Nilssons gata 49, SE-20502, Malmö, Sweden. kristina.lang@med.lu.se.
Kristina
http://orcid.org/0000-0001-9250-1897
K
Lång
Department of Diagnostic Radiology, Translational Medicine Malmö, Lund University, Inga Marie Nilssons gata 49, SE-20502, Malmö, Sweden.
Ingvar
I
Andersson
Epidemiology and Register Centre South, Skåne University Hospital, Klinikgatan 22, SE-221 85, Lund, Sweden.
Aldana
A
Rosso
Department of Medical Radiation Physics, Translational Medicine Malmö, Lund University, Inga Marie Nilssons gata 49, SE-20502, Malmö, Sweden.
Anders
A
Tingberg
Department of Medical Radiation Physics, Translational Medicine Malmö, Lund University, Inga Marie Nilssons gata 49, SE-20502, Malmö, Sweden.
Pontus
P
Timberg
Department of Diagnostic Radiology, Translational Medicine Malmö, Lund University, Inga Marie Nilssons gata 49, SE-20502, Malmö, Sweden.
Sophia
S
Zackrisson
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D011159:Population Surveillance; D011446:Prospective Studies; D015203:Reproducibility of Results; D013548:Sweden / Q000453:epidemiology; D014056:Tomography, X-Ray / Q000379:methods*
Breast Cancer; Diagnostic Imaging; Mammography; Screening; Women’ Health