News | September 19, 2014

Tops Breast Center Reader Study Compares Prospective Tomosynthesis Interpretations With Retrospective Readings of the Corresponding FFDM

Tops Breast Center Study Tomosynthesis FFDM

September 19, 2014 — Tops Comprehensive Breast Center, Houston, was a part of a recent study conducted by Stephen L. Rose, M.D., medical director of Tops Comprehensive Breast Center, and colleagues (Andra L. Tidwell, BSRT (R)(M); Mary F. Ice, M.D.; Amy S. Nordmann, M.D.; Russell Sexton Jr., DO; Rui Song, M.D.) conducted exclusively at Tops, leading to advancements in screening mammography and 3-D mammography.

In the United States, women have routine full-field digital mammography (FFDM). This exam, while widely accepted, has known pitfalls when it comes to high recall rates and low cancer detection when used as the sole screening method. While new screening tools are constantly being tested and discovered for early detection, digital breast tomosynthesis (DBT) has been proven as one of the better approaches. DBT enables the reconstruction of cross-sectional images aimed to assist radiologists with the interpretation process through better visualization of breast tissue.

Rose and colleagues set out to compare performance of prospective interpretations of clinical tomosynthesis (DBT) plus FFDM examinations with retrospective readings of the corresponding FFDM examinations alone.

For the study, seven Mammography Quality Standard Act-qualified radiologists interpreted 10,878 FFDM examinations that had been interpreted by other radiologists using a combination of FFDM and DBT. When comparing recall rates between the two clinical interpretations, those interpretations that had utilized both FFDM and DBT recalled 588 cases; compared to those that depended only on FFDM where 888 cases were recalled.

While none of the technologies used currently are perfect, it is hard to deny the benefit of FFDM and DBT together to exclude outliers and identify more clearly which screenings will indeed require a diagnostic work up. The consistency of the findings for the group was not only encouraging, but also a confidence builder that the combination of DBT plus FFDM for screening women resulted in a 35 percentreduction in recall rates and a simultaneous increase in cancer detection rates when compared to retrospective interpretations of corresponding FFDM examinations alone. The study showed an increase of 55 percent more cancers were found than digital mammography alone and increased detection of invasive cancers by 66 percent.

Rose stated, “This study should put to rest much of the current confusion over the benefits of mammography. With this new technology, tomosynthesis (3-D mammography), we can significantly reduce the patient anxiety generated by recalls for additional imaging. Simultaneously, the new technology will increase the accuracy of traditional digital mammography in the early detection of invasive tumors.”

Rose and Andra Tidwell, BSRT, imaging director of Tops Comprehensive Breast Center, also published a study last year in the American Journal of Radiology comparing 3-D screening with the prior year’s standard digital mammography. The study actually demonstrated a 37 percent reduction in recalls and over a 50 percent increase in the early detection of invasive tumors. “I truly believe that as experience grows with 3-D mammography, we will see the recall rates continue to drop, and we will detect tumors earlier when less treatment is required. This is a very exciting study for all women undergoing screening mammography,” stated Rose.

Tops Comprehensive Breast Center has served the North Houston area for more than 10 years and has a team passionately devoted to providing patients with high quality breast care. Tops Comprehensive Breast Center, with locations in North Houston, Willowbrook, Kingwood and The Woodlands, is recognized as a Breast Imaging Center of Excellence by American College of Radiology (ACR). Tops Comprehensive Breast Center is affiliated with Tops Surgical Specialty Hospital, a patient centered, physician driven healthcare facility managed by United Surgical Partners International. Both the Hospital and Breast Centers are committed to their mission: To provide first-class surgical services for the local community in a safe, comfortable and welcoming environment; one in which we would be happy to treat our own families.

For more information: www.academicradiology.org/article/S1076-6332(14)00152-4/abstract

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