Mega trial looks to compare efficacy of 2D and 3D mammography

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ECOG-ACRIN Cancer Research Group (ECOG-ACRIN) and the National Cancer Institute (NCI) are leading the Tomosynthesis Mammographic Imaging Screening Trial (TMIST), the first randomized trial to compare 2D and 3D digital mammography screening.

The study aims to provide insight on how to most effectively screen women for breast cancer and help them make decisions about future screening tests .

“Nearly 50 million screening mammograms occur each year in the United States, yet it has been decades since a large-scale randomized trial of mammography has been done,” said Worta McCaskill-Stevens, MD, director of the NCI Community Oncology Research Program (NCORP). “The evolution of mammography technology provides us with an opportunity to fill in the gaps in our knowledge about two available breast cancer screening tests.”

The researchers are looking to enroll 165,000 healthy women ages 45 to 74 who are planning to get routine mammograms. The research will compare both conventional (2D) and tomosynthesis (3D).

Though 3D detects more findings that require follow up, it can lead to more treatments and sometimes unnecessary procedures. It is currently not known if 3D technology reduces the risk of developing advanced cancer compared to 2D mammography.

“We need to determine if 3D mammography is better than 2D at finding the sort of breast cancers that are most likely to spread and kill women,” said ECOG-ACRIN study chair Etta D. Pisano, MD, vice chair of research in the department of radiology at Beth Israel Deaconess Medical Center and professor in residence of radiology at Harvard Medical School in Boston. “If a newer screening technology does not reduce the numbers of advanced, life-threatening cancers, then are we really improving screening for breast cancer?”

Comprehensive data on each mammogram will be collected until the end of the study in 2025. Findings reported will include imaging that shows no signs of cancer, findings suspicious of cancer and breast cancer. Further, the researchers also intend to report breast cancer status, treatment and outcomes.