DBT reduces recall rates, number of patients for short-term follow up

Implementing three-dimensional (3D) digital breast tomosynthesis (DBT) to standard digital mammography (DM) can reduce the number of patients committed to short-term follow-up screening, according to research published online Jan. 19 in Academic Radiology.  

Researchers led by Tricia Stepanek, from Case Western Reserve University School of Medicine in Cleveland, Ohio, found that using DBT with digital mammography decreased the number of patients assigned to short-term follow-up by 10.3 per 1,000 women while maintaining comparable rates of delayed cancer detection.  

The researchers compared a total of 11,478 DM screening exams before implementation (September 2010 through August 31, 2011) to 9,350 DM and DBT screening exams (January 2014 through June 30, 2015) after implementation.   

Examinations were read by one of five radiologists and lesions assigned a BI-RADS category 3 at diagnostic exam were classified as architectural distortions, asymmetries, calcifications, masses and “other” and were followed for a minimum of two years. 

The researchers found that BI-RADS category 0 classifications (“additional imaging needed”) dropped from 13 percent to 11.8 percent of examinations.  

Additionally, the percentage of BI-RADS category 3 classification (“probably benign”) fell from 3.4 percent of examinations to 2.4 percent. The overall number of patients assigned to short-term follow-up was reduced by 10.3 per 1,000 women, according to the researchers.  

They noted that the combination of DM and DBT exposes patients to higher levels of radiation, however the method may result in both economic savings and improved patient outcomes.  

“This reduction in the number of women committed to short-term follow-up has the potential for downstream effects including decreased patient anxiety, improved patient outcomes, and decreased false positive mammograms,” Stepanek et al. wrote. “In addition, the increased cost savings of avoiding follow-up diagnostic imaging is likely to outweigh the initial cost of DBT with screening.”