title: Digital breast tomosynthesis (3D-mammography) screening: A pictorial review of screen-detected cancers and false recalls attributed to tomosynthesis in prospective screening trials.
abstract: This pictorial review highlights cancers detected only at tomosynthesis screening and screens falsely recalled in the course of breast tomosynthesis screening, illustrating both true-positive (TP) and false-positive (FP) detection attributed to tomosynthesis. Images and descriptive data were used to characterise cases of screen-detection with tomosynthesis, sourced from prospective screening trials that performed standard (2D) digital mammography (DM) and tomosynthesis (3D-mammography) in the same screening participants. Exemplar cases from four trials highlight common themes of relevance to screening practice including: the type of lesions frequently made more conspicuous or perceptible by tomosynthesis (spiculated masses, and architectural distortions); the histologic findings (both TP and FP) of tomosynthesis-only detection; and the need to extend breast work-up protocols (additional imaging including ultrasound and MRI, and tomosynthesis-guided biopsy) if tomosynthesis is adopted for primary screening.
authors.affiliation: Screening and Test Evaluation Program, School of Public Health (A27), Sydney Medical School, University of Sydney, Sydney 2006, Australia. Electronic address: nehmat.houssami@sydney.edu.au.
authors.forename: Nehmat
authors.initials: N
authors.lastname: Houssami
authors.affiliation: Department of Medical Radiology, Translational Medicine Malmö, Lund University, Lund, Sweden.
authors.forename: Kristina
authors.initials: K
authors.lastname: Lång
authors.affiliation: U.O. Senologia Clinica e Screening Mammografico, Department of Diagnostics, Ospedale di Trento, Azienda Provinciale Servizi Sanitari, Trento, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Bernardi
authors.affiliation: Institute of Anatomy, Department of Experimental Medicine, University of Genoa, Largo Rosanna Benzi 8, 16132 Genoa, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Tagliafico
authors.affiliation: Department of Medical Radiology, Translational Medicine Malmö, Lund University, Lund, Sweden.
authors.forename: Sophia
authors.initials: S
authors.lastname: Zackrisson
authors.affiliation: Department of Radiology, Oslo University Hospital Ullevaal, University of Oslo, Norway.
authors.forename: Per
authors.initials: P
authors.lastname: Skaane
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D055088:Early Detection of Cancer / Q000379:methods / Q000706:statistics & numerical data*; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods / Q000706:statistics & numerical data; D008327:Mammography / Q000379:methods / Q000706:statistics & numerical data*; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity
keywords: Breast cancer detection; Cancer screening; Digital breast tomosynthesis; False-positive recall; Mammography; Population screening