Future of Breast Cancer Screening with Digital Breast Tomosynthesis
Full-field digital mammography (FFDM) is currently the gold standard in breast cancer screening.1 It delivers high-resolution images of the breast, but it has a limitation that’s inherent to the acquisition method: tissue superimposition. To resolve this issue, in recent years digital breast tomosynthesis (DBT) has been introduced in clinical practice. It provides 3D information about breast tissue by acquiring images at different angles, and it offers better cancer detection rates.2 DBT has become an established method in the clinical routine, and in the near future it may replace digital mammography as the breast screening modality of choice.
What do our clinical experts have to say?
The latest results of clinical trials were presented at a Breast Care Day symposium at the ECR 2019. The studies were analyzed in terms of their effectiveness in population screening, and the remaining knowledge gaps were identified.
What should the future of breast cancer screening with digital breast tomosynthesis look like?
The future of breast cancer screening with DBT is a highly debated topic. There are various factors to be considered. Associate Prof. Dr. Ioannis Sechopoulos (Raboud University Nijmegen/NL) gives an overview of the key parameters for screening programs, with a special emphasis on the role of dose. (ECR, March 2019)
Conclusion from the Malmö Breast Tomosynthesis Screening Trial – a concept for breast screening
The Malmö Breast Screening Trail focuses on DBT screening performance, effectiveness and reduced reading time. Prof. Dr. Sophia Zackrisson (Lund University, Malmö/Sweden) concludes that 1-view tomosynthesis with minimum compression increases cancer detection and can be feasible in screening. (ECR, March 2019)
Comparison of Two-dimensional and Three-dimensional Mammography Performance in Breast Cancer Screening
This talk of Dr. Dag Pavic (Medical University of South Carolina, Mount Pleasant, SC / USA) gives an overview about researchers at MUSC that are currently comparing 2D to 3D and 1-view 3D in breast screening. Initial results show that with 1-view, they save time and dose, while achieving a higher detection rate compared to 2D. Can we omit 2D acquisition in the future? (ECR, March 2019)
View of future screening programs: Conclusion from the Malmö Breast Tomosynthesis Screening Trial – A concept for breast screening
Sophia Zackrisson; Malmö, Sweden
According to some of the important principles of screening established by WHO in 1968, a screening test should be fast, safe, efficient, and acceptable for the target population. Screening with 2D mammography fulfills many of these prerequisites, but how will digital breast tomosynthesis, DBT, fit in? The organization and workflow in mammography screening is long-standing and well-established in many countries, and changes may have a great impact on these issues.
This talk will focus on the facts about digital breast tomosynthesis regarding screening performance, effectiveness, and possible measures to reduce reading time. When planning the Malmö Breast Tomosynthesis Screening Trial we took the principles of screening into consideration and used 1-view DBT and reduced compression. Furthermore, artificial intelligence in combination with the radiologist opens up possibilities for further future improvements.