Greg Freiherr, Industry Consultant

Greg Freiherr has reported on developments in radiology since 1983. He runs the consulting service, The Freiherr Group.

Blog | Greg Freiherr, Industry Consultant | June 26, 2015

JAMA Study Boosts Credibility of Screening Mammo

Call-backs have always been a problem in mammography. They are a source of worry, added discomfort, well-founded patient complaints about the inefficiency of breast exams, and unnecessary cost. More than that, they call into question the credibility of an exam whose use depends on women’s belief in its value.

 

Now a study, published June 25 issue of the Journal of the American Medical Association (JAMA), has found that the addition of 3-D imaging, widely known as breast tomosynthesis, substantially decreases the proportion of patients who are called back, just as its use finds more cancers than the use of 2-D digital mammography alone — a 41 percent increase in the detection of invasive breast cancers and a 29 percent increase in the detection of all breast cancers.
 
While the data indicating improved performance due to the use of breast tomo is welcome, they come as no surprise. The FDA approved the sale of 3-D imaging systems for breast cancer screening in 2011 because studies showed its addition to standard digital mammography uncovers more cancers, just as it reduces false positives. Its effect on recall rates, however, has been largely anecdotal. The just published JAMA study changes that. 
 
Data acquired at 13 U.S. centers performing 454,850 screening exams (61 percent of which involved only 2-D digital mammography for comparison) found that the addition of tomo dropped the recall rate from 107 to 91 per 1,000 screening exams — a 15 percent decrease. This translates to 16 fewer recalls per 1,000 screening exams. 
 
The study is good news for women in general and Hologic in particular. The company’s Selenia Dimensions is the only breast tomography system currently approved by the FDA for sale in the United States. More than 1,000 of these systems are operating across all 50 states, according to the company, including those at the five academic hospitals and eight community-based sites participating in the study. 
 
Hologic framed the study as addressing the two most frequently cited concerns about breast cancer screening — unnecessary recalls and finding cancers that do not need to be treated. The latter was demonstrated by the 41 percent increase in the detection of invasive breast cancers; the former by a double digit reduction in the recall rate.  
 
It’s hard to overestimate the importance of these findings. Screening mammography  exposes women with no known sign of disease  to ionizing radiation, which itself can cause cancer. As such, they deserve the greatest possible assurance that the exam they undergo is done with the least chance of being wrong. The JAMA study documents that the routine use of tomosynthesis in breast cancer screening does exactly this, providing women the reason to believe that modern mammography truly is a potentially life-saving tool. 
 

Related Content

This is an example of 3-D ultrasound imaging on a breast, designed to help increase efficiency and diagnostic accuracy in any practice. Image courtesy of Hologic.

This is an example of 3-D ultrasound imaging on a breast, designed to help increase efficiency and diagnostic accuracy in any practice. Image courtesy of Hologic.

Feature | Breast Imaging | September 15, 2021 | By Jennifer Meade
The...
While the Mammography Quality Standards Act (MQSA) and the introduction of EQUIP (Enhancing Quality Using the Inspection Program) have been successful in standardizing and enhancing mammographic imaging quality, inadequate breast positioning can dramatically impact the ability of radiologists and technicians to quickly and accurately detect breast cancer and potentially malignant lesions in their patients

Getty Images

Feature | Mammography | September 15, 2021 | By Christopher Austin, M.D. and Randy D. Hicks, M.D., MBA
Plan to attend RSNA21 at McCormick Place Chicago, Nov. 28 – Dec. 2, 2021

Getty Images

News | RSNA | September 13, 2021
September 13, 2021 — The Radiological Society of North America (RSNA) today announced highlights of the Technical Exh
According to ARRS’ American Journal of Roentgenology (AJR), immediately reading screening mammograms during the coronavirus disease (COVID-19) pandemic promises a new and improved paradigm—reducing care disparities, while increasing the speed of diagnostic workup.

Flow Chart of Patient Selection

News | Breast Imaging | September 09, 2021
September 9, 202
Laws designed to help women with increased risk for missed breast cancer diagnoses may help catch the disease earlier, according to Penn State College of Medicine researchers.

Getty Images | AleksandarNakic

News | Breast Imaging | September 09, 2021
September 9, 2021 — Laws designed to help women with increased risk for...

Image of a STING protein, courtesy of UCLA Jonsson Comprehensive Cancer Center

News | PET Imaging | September 08, 2021
September 8, 2021 — A new study from scientists at the UCLA Jonsso...
62-Year-Old Woman Who Underwent Hysterectomy for Uterine Cancer: Sagittal chest CT images demonstrate measurement of right (A) and left (B) lung length at hilar level from apex to diaphragmatic dome. Right lung length was 20.1 cm for reader 1 and 20.0 cm for reader 2; left lung length was 21.7 cm for reader 1 and 21.3 cm for reader 2. Patient did not require postoperative mechanical ventilation.

62-Year-Old Woman Who Underwent Hysterectomy for Uterine Cancer: Sagittal chest CT images demonstrate measurement of right (A) and left (B) lung length at hilar level from apex to diaphragmatic dome. Right lung length was 20.1 cm for reader 1 and 20.0 cm for reader 2; left lung length was 21.7 cm for reader 1 and 21.3 cm for reader 2. Patient did not require postoperative mechanical ventilation.

News | Computed Tomography (CT) | September 07, 2021
Neuroscientists at the Beckman Institute for Advanced Science and Technology carried out comparative studies to determine safe operating conditions for multiband EEG-fMRI imaging while maintaining acceptable data quality standards

A team of psychologists and neuroscientists at the Beckman Institute for Advanced Science and Technology including Sepideh Sadaghiani, Maximillian Egan, Ryan Larsen, and Brad Sutton published a study to establish safe use of electroencephalography coupled with newly developed functional MRI sequences. Image courtesy of the Beckman Institute for Advanced Science and Technology.

News | Magnetic Resonance Imaging (MRI) | September 07, 2021
September 7, 2021 — A team of psychologists and neuroscientists at the Beckman Institute for Advanced Science and Tec
The researchers say there is currently a lack of good quality evidence to support a policy of replacing human radiologists with artificial intelligence (AI) technology when screening for breast cancer.

Getty Images

News | Artificial Intelligence | September 02, 2021
September 2, 2021 — Humans still seem to be better than technology when it comes to the accuracy of spotting possible