Early detection of breast cancer through effective screening can help identify breast tumors early and thus provide a better chance for treatment. Guidelines for screening mammography vary around the world, particularly with regard to age and sex.
Early detection of breast cancer through effective screening can help identify breast tumors early and thus provide a better chance for treatment. Guidelines for screening mammography vary around the world, particularly with regard to the age of initiation and the screening interval.
One of the main tools for this purpose, Conventional two-dimensional mammography can cause both false positive and false negative results.High repeat rates coupled with the failure to detect approximately 30% of breast cancers highlight the need to improve the effectiveness of breast cancer detection during screening.
Under this scenario arises the digital breast tomosynthesis (DBT)also known as three-dimensional mammography. Its procedure is based on acquiring multiple low-dose X-rays of the breast at different angles along an arc, which are reconstructed as a pseudo-three-dimensional image. This allows the breast tissue to be seen in thin sections that help reduce the confounding effects of tissue superposition, allowing for better identification, localization, and characterization of lesions.
The results derived from TDM are highlighted in a study inserted in ‘Radiology’, the official publication of the Radiological Society of North America, where it is concluded that “The new three-dimensional form of breast cancer screening, known as digital breast tomosynthesis (DBT), is more effective at detecting breast cancer than traditional 2D digital mammography (DM).
That’s the conclusion of an analysis of 13 years of screening data by researchers at the Yale Cancer Center. The data also suggest that 3-D mammograms may reduce the incidence of advanced cancer diagnoses.
Faster detection
“Most of the time, cancers are detected earlier with 3D mammograms“said co-lead author Dra. Liane Philpotts, Professor of Radiology and Biomedical Imaging at Yale School of Medicine (YSM) and a member of the Yale Cancer Center.
CT reconstructs images of the breast taken from different angles into 3D images, while DM takes images of the breast from two angles. YSM radiologists at Yale New Haven Health (YNHH) adopted the new DBT technology in 2011.
Researchers analyzed 1,407 breast cancer cases detected between August 2008 and July 2021, including 35,544 diabetes mellitus screenings and 237,394 TCD screenings. Researchers compared a variety of data, including patient demographics, imaging results, and pathology reports.
The results showed that TDM had a higher cancer detection rate than DM (5.3 versus 4 per 1000 screening tests) without leading to overdiagnosis of less harmful cancers that should not affect the patient’s life.
Additionally, the false-positive rate (when a woman undergoes additional testing after a screening finds a noncancerous abnormality in her breast) was significantly lower for TDM, at 7.2 percent, compared with 10.6 percent for DM.And over time, when women have repeated 3-D mammograms, the number of advanced cancers diagnosed is even lower.”added Dr. Philpotts.
Despite evidence in favor of the use of digital breast tomosynthesis in the detection and diagnosis of breast cancer, More research is needed to verify whether this technique really helps to increase the detection of low-grade cancers. that may not affect patient outcomes, or whether it helps improve the detection of more aggressive cancers at an earlier stage, which could translate into better patient outcomes.
