title: Impact of the Addition of Digital Breast Tomosynthesis (DBT) to Standard 2D Digital Screening Mammography on the Rates of Patient Recall, Cancer Detection, and Recommendations for Short-term Follow-up.
abstract: The addition of digital breast tomosynthesis (DBT) to digital screening mammography (DM) has been shown to decrease recall rates and improve cancer detection rates, but there is a lack of data regarding the impact of DBT on rates of short-term follow-up. We assessed possible changes in performance measures with the introduction of DBT at our facility.
  
  
  
  In our observational study, databases were used to compare rates of recall, short-term follow-up, biopsy, and cancer detection between women undergoing DM without (n = 10,477) and women undergoing DM with (n = 2304) the addition of DBT. Regression analysis was performed to determine associations with patient age, breast density, and availability of comparison examinations.
  
  
  
  The addition of DBT resulted in significantly lower recall rates (16%-14%, P = .017), higher rates of biopsy (12.7%-19.1%, P < .01), and increased detection of ductal carcinoma in situ, with a difference of 2.3 cases per 1000 screens (P = .044). A 33% increase in cancer detection rates was observed with DBT, which did not reach statistical significance. Short-term follow-up of probably benign findings was 80% higher in the DBT group (odds ratio = 1.80, 95% confidence interval = 1.38-2.36, P < .001).
  
  
  
  To our knowledge, we are the first to study the impact of DBT on rates of short-term follow-up, and observed an 80% increase over the DM group. Further research is needed to determine the malignancy rate of Breast Imaging Reporting and Data System 3 lesions detected with DBT, and establish appropriate follow-up to maximize cancer detection while minimizing expense and patient anxiety.
authors.affiliation: Department of Radiology, The Ohio State University Wexner Medical Center, 395 W. 12th Ave., Columbus, OH 43210. Electronic address: powell.jaclynn@gmail.com.
authors.forename: Jaclynn L
authors.initials: JL
authors.lastname: Powell
authors.affiliation: Department of Radiology, The Ohio State University Wexner Medical Center, 395 W. 12th Ave., Columbus, OH 43210.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Hawley
authors.affiliation: Department of Radiology, The Ohio State University Wexner Medical Center, 395 W. 12th Ave., Columbus, OH 43210.
authors.forename: Adele M
authors.initials: AM
authors.lastname: Lipari
authors.affiliation: Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus, Ohio.
authors.forename: Vedat O
authors.initials: VO
authors.lastname: Yildiz
authors.affiliation: Department of Radiology, The Ohio State University Wexner Medical Center, 395 W. 12th Ave., Columbus, OH 43210.
authors.forename: B Selnur
authors.initials: BS
authors.lastname: Erdal
authors.affiliation: Department of Radiology, The Ohio State University Wexner Medical Center, 395 W. 12th Ave., Columbus, OH 43210.
authors.forename: Selin
authors.initials: S
authors.lastname: Carkaci
mesh_terms: D000328:Adult; D001706:Biopsy; D001940:Breast / Q000000981:diagnostic imaging / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies
keywords: BIRADS 3; DBT; DCIS; short-term follow-up; tomosynthesis