Synthesized 2D mammo emerges as a worthy low-dose screening option

Digital mammography combined with digital breast tomosynthesis is better than digital mammography alone at finding cancers and reducing recall rates. But another combo has now proven just as good at detection, better at cutting recalls and especially impressive at reducing radiation dose.

That winning combo would be synthesized two-dimensional mammography and digital breast tomosynthesis (s2D/DBT).

Researchers at the Hospital of the University of Pennsylvania in Philadelphia compared the performance of the two combinations in 15,571 women screened at that institution with digital mammography/DBT and 5,366 women screened there with s2D/DBT.

Publishing their findings online ahead of print in Radiology, Samantha Zuckerman, MD, and colleagues report that they found no significant difference in cancer detection rate for s2D/DBT vs. digital mammography/DBT (5.03 of 1,000 vs. 5.45 of 1,000, respectively).

They also report:

  • The recall rate for s2D/DBT significantly decreased compared with digital mammography/DBT screening (7.1 percent vs. 8.8 percent, respectively).
  • Cancers per biopsy performed were higher in s2D/DBT compared with digital mammography/DBT screening (38.6 percent vs. 27.0 percent).
  • The recall rate for calcified lesions and asymmetries was lower with s2D/DBT compared with digital mammography/DBT screening (1.1 percent vs. 1.6 percent and 3.2 percent vs. 4.5 percent).
  • The average glandular radiation dose was 39 percent lower in s2D/DBT vs. digital mammography/DBT (4.88 mGy vs. 7.97 mGy).

“Because of the reduction in radiation dose, the replacement of digital mammography with s2D mammography is beneficial to women who undergo breast cancer screening,” the authors conclude. “The results from this early implementation study demonstrate that s2D mammography may be an acceptable replacement to digital mammography/DBT in screening because reduced recall rates and cancer detection rates are maintained.”

The authors acknowledge several limitations inherent in their study, including their concentration on a single vendor’s technology as used at a single provider institution.

Additional info on the study with an eye on the technology is available in a press release sent by Hologic.