Marilyn A. Barry-Brooks MD, Presenter: Nothing to Disclose

Ana P. Lourenco MD, Abstract Co-Author: Nothing to Disclose

Martha Beretta Mainiero MD, Abstract Co-Author: Nothing to Disclose

To compare the recall rate, biopsy positive predictive value, and cancer detection rate prior to and following the implementation of screening tomosynthesis.

This retrospective analysis was IRB approved and HIPAA compliant. Results from all digital screening mammography exams performed without tomosynthesis from March through December 2011 and results from all digital screening mammography exams performed with tomosynthyesis from March through December 2012 were reviewed. Diagnostic cases were excluded. All studies were interpreted by radiologists with fellowship training in breast imaging. Recall rates, biopsy positive predictive values, and cancer detection rates were determined. The biopsy positive predictive value was defined as the number of BI-RADS 4/5 biopsies positive for malignancy divided by the number of BI-RADS 4/5 cases that underwent biopsy. Cancer detection rate was calculated by dividing the total number of malignancies identified (including BI-RADS 3 cases undergoing biopsy that showed malignancy and high risk lesions at biopsy that were upgraded to malignancy at surgical excision) by the total number of screening exams. Statistical analysis was performed using a two-sample test of proportions.

A total of 11,818 patients underwent digital mammography screening and 11,794 patients underwent digital mammography plus tomosynthesis screening. The recall rate for the pre tomosynthesis group was significantly higher at 8.6%, compared with 6.0% for the tomosynthesis group (p<.001). There was no significant difference in the biopsy positive predictive values (30.5% pre tomosynthesis vs 27.1% post tomosynthesis, p=0.48) or cancer detection rates per thousand patients screened (4.9 in the pre tomosynthesis group vs 4.7 in the tomosynthesis group, p=0.82).

The addition of tomosynthesis to digital mammography in this screening population significantly reduced the recall rate without decreasing the biopsy positive predictive value or cancer detection rate.

A 30% decrease in recall rate following the addition of tomosynthesis to mammography screening may result in decreased patient anxiety and healthcare costs.

Barry-Brooks, M, Lourenco, A, Mainiero, M, Breast Cancer Screening Pre and Post-tomosynthesis: Comparison of Recall Rate, Biopsy Positive Predictive Value, and Cancer Detection Rate.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13017260.html