Nelly Salem MD, Presenter: Nothing to Disclose

Cheryl L Thompson, Abstract Co-Author: Nothing to Disclose

Donna M. Plecha MD, Abstract Co-Author: Advisory Board, Hologic, Inc Research Grant, SuperSonic Imagine

To compare the rates and tumor characteristics of interval cancers diagnosed in patients screened with full field digital mammography (FFDM) versus those screened with FFDM plus digital breast tomosynthesis (DBT).

Cancer patients diagnosed from 9/1/2011-12/31/2013 were evaluated, determining if they were interval cancers from a population screened from 9/1/2011-12/31/2012. Patients were separated into two groups: those who were screened with FFDM versus FFDM + DBT. Interval cancers were defined as those that presented less than a year of a negative screening mammogram with a symptom. Age, breast density, interval time period from a negative mammogram, tumor size, stage, lymph node status, and treatment regimens were recorded.

15,551 women were screened between 9/1/2011 and 12/31/2012 with 11,185 screened with FFDM and 4,366 women screened with FFDM + DBT. Overall 22 interval cancers were identified, 18 were patients who underwent screening with FFDM, and 4 were screened with FFDM + DBT. This is a non-significant 38% lower interval cancer rate of 1 cancer per 1000 patients screened with FFDM + DBT versus 1.6/1000 interval cancers in patients screened with FFDM alone (p=0.43). Overall mean cancer patient age was 62, and there was a mean of 7.7 months interval at time of diagnosis since the screening exam, with no significant difference between the two groups. When comparing the two groups of interval cancer patients, there was no statistical significance in breast density, cancer grade, stage, size, lymph node status, mastectomy rate, rate of chemotherapy or radiation therapy between the two groups.

Our results show a non-significant 38% lower interval cancer rate when screening with FFDM + DBT versus FFDM alone. We found no significant difference between the two groups of interval cancer patients comparing age, breast density, interval time at diagnosis, cancer grade, stage, size, lymph node status, mastectomy rate, rate of chemotherapy or radiation therapy.  

DBT is a promising supplement to mammographic screening for breast cancer. Studies have shown decreased recall rates and increased cancer detection rates, however the effect on interval cancers has not been evaluated. Our results demonstrate no significant difference in: the interval cancer rate or characteristics of the interval cancers between patients screened with DBT + FFDM versus FFDM alone.

Salem, N, Thompson, C, Plecha, D, Interval Cancers in Patients Screened with Full Field Digital Mammography (FFDM) vs FFDM plus Digital Breast Tomosynthesis (DBT).  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14010868.html