New research supports use of 3D Mammography

By Dr Eamonn McAteer, South Coast Radiology.

Mammography is the most commonly used examination for breast cancer screening, however it remains an imperfect test. A standard two-view mammogram does not detect all cancers, and even in leading imaging centres, maximum sensitivity for breast cancer detection is 85%, with sensitivity decreasing as breast tissue density increases.

A number of newly published research studies have proven that digital breast tomosynthesis, commonly known as 3D mammography, provides more accurate breast imaging with a statistically significant increase in cancer detection and reduction in false positives. South Coast Radiology offers 3D Mammography at our Women’s Imaging Centre in Southport where it is offered to all women as an adjunct to standard 2D digital mammography. A summary of the recent publications is provided below.

STORM trial published in The Lancet Oncology, Volume 14, Issue 7,June 2013. The study, "Integration of 3D digital mammography with tomosynthesis for population breast-cancer screening (STORM): a prospective comparison study," was led by a team of Italian and Australian researchers, represented by Assoc. Prof. Houssami, University of Sydney's School of Public Health. The study investigated whether 2D + 3D mammography was more effective at detecting cancers and reducing false positives than 2D screening alone. The analysis was based on the imaging examinations of 7,292 women, average age of 58, provided at two Italian sites. Significant findings include: 3D mammography provided a 50% improvement in number of cancers detected and a 17% reduction in recall rate.

Implementation of Breast Tomosynthesis in a Routine Screening Practice: an Observational Study published in American Journal of Roentgenology, June 2013, Volume 200. Researchers from TOPS Comprehensive Breast Centre in Houston evaluated recall, biopsy, and cancer detection rates, and calculated PPVs before and after the introduction of 3D mammography for routine screening. 13,856 women received 2D mammography alone, while 9,499 women underwent both 2D and 3D mammography. The team reported the following when 3D mammography was used: 11% drop in biopsy rate; a 35% increase in overall cancer detection rate with a 54% increase in the invasive cancer detection rate, and a 5% increase in the positive predictive value for recalls.

Breast Tomosynthesis Increases Cancer Detection and Reduces Recall Rates, presented at the annual meeting of the Radiological Society of North America (RSNA). Researchers from the Perelman School of Medicine at the University of Pennsylvania compared 3D mammography of 15,633 women with 2D mammography of 10,753. Overall, researchers found that 3D mammography decreased recalls by 18.5%, and increased detection of all cancers by 46%.

These recent publications provide additional confirmation of the compelling benefits of 3D mammography which we have also seen on a daily basis with the introduction of the technology to our Women’s Imaging Centre. Not only are we finding cancers earlier, we're also eliminating some of the stress, complications and expense associated with false positives requiring mammographically guided stereotactic breast biopsies.

For further details please contact one of our specialised breast imaging radiologists on 07 5564 085107 5564 0851.