Elizabeth McDonald MD, PhD, Presenter: Nothing to Disclose

Susan Weinstein MD, Abstract Co-Author: Nothing to Disclose

Anne Marie McCarthy, Abstract Co-Author: Nothing to Disclose

Marie Synnestvedt, Abstract Co-Author: Nothing to Disclose

Mitchell Dennis Schnall MD, PhD, Abstract Co-Author: Nothing to Disclose

Emily F. Conant MD, Abstract Co-Author: Scientific Advisory Board, Hologic, Inc

(1) Compare the utilization of BIRADS category 3 (BR3, recommend short-interval follow-up) after a recall from screening before and after implementation of screening digital breast tomosynthesis (DBT). (2) Determine whether DBT will reduce the use of short-interval follow-up by lesion subtype.

Retrospective IRB approved review of 15,633 screening DBT exams from 10/1/2011-2/28/2013 and 10,751 screening digital mammography (DM) exams from 9/1/2010-8/30/2011 was performed. The initial recall populations for DM and DBT were 1116 and 1372, respectively. That group was further searched for a de novo assignment of category 3. Exams were cataloged according to finding type: calcifications (C), asymmetry or focal asymmetry (A), mass (M), and architectural distortion (AD). Some exams were recalled for more than one finding type. Differences between groups were compared using Wilcoxon Rank Sum Test.

There were significantly less patients recommended for short-interval follow-up in the DBT cohort (172/10751, 1.6% DM versus 203/15633, 1.3% DBT, p=0.042). However, this difference was no longer significant when the lower recall rate of the DBT cohort was taken into account (172/1116, 15.4% DM versus 203/1372, 14.8% DBT, p=0.70). The finding types given a BR3 for the DM cohort were C (67/172, 39.0%), M (41/172, 23.8%), A (71/172, 41.3%), and AD (5/172, 2.9%) and DBT cohort, C (66/203, 32.5%), M (62/203, 30.5%), A (96/203, 47.3%) and AD (9/203, 4.4%). There was no significant difference in the use of BR3 for any finding type (p=0.20, 0.15, 0.24 and 0.44, respectively).

Screening DBT does not reduce the frequency of BR3 assessment after recall from screening and also does not change the types of findings recommended for short-interval follow-up.

Screening with DBT does not reduce the number of patients recommended for short-interval follow-up after initial diagnostic evaluation.

McDonald, E, Weinstein, S, McCarthy, A, Synnestvedt, M, Schnall, M, Conant, E, Comparison of the Use of BIRADS Category 3 before and after Implementation of Digital Breast Tomosynthesis in a Large Screening Population.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14016551.html