"This is the first major advance in breast imaging and breast cancer screening since the development of breast MRI," said lead researcher Elizabeth A. Rafferty, M.D., director of Breast Imaging at the Avon Comprehensive Breast Center at Massachusetts General Hospital in Boston. "The beauty of tomosynthesis is that it addresses two major concerns with screening mammography: missed cancers and false positive rates."
According to the National Cancer Institute, there is convincing evidence that screening mammography reduces breast cancer mortality in women between the ages of 40 and 74. However, as many as 30 percent of breast cancers are not detected by mammography and an additional eight to 10 percent of women who undergo a screening mammogram are recalled for further testing when no cancer is present (called a false positive result).
Unlike a screening digital mammogram, which involves two X-ray images of each breast, breast tomosynthesis captures multiple, low-dose images from different angles around the breast. The images are then used to produce a three-dimensional reconstruction of the breast. Both digital mammography and breast tomosynthesis, which was approved by the United States Food and Drug Administration (FDA) in February of 2011, can be performed on the same mammography equipment in rapid succession.
Dr. Rafferty's study involved 1,192 women recruited from five sites, of whom 997, including 780 screening cases and 217 women who needed pre-biopsy breast imaging, had complete data sets. Each of the women underwent a standard digital mammogram followed by breast tomosynthesis. The total radiation dose for the combined procedure was less than 3 milligray, which is the FDA limit for a single mammogram.
Drawing from the eligible cases, the researchers then conducted two reader studies involving 312 and 310 cases, respectively. Twelve radiologists participated in the first reader study; 15 radiologists in the second. A total of 48 cancers were included in the first reader study; 51 cancers in the second.
Compared to digital mammography alone, the use of both standard mammogram and tomosynthesis resulted in increased diagnostic accuracy for all 27 radiologists. Additionally, the diagnostic sensitivity of the combined exam — or the rate at which cancer present in the breast was correctly identified — increased by 10.7 percent for radiologists in Reader Study 1 and 16 percent for radiologists in Reader Study 2.
"Almost all of the gains in diagnostic sensitivity with the combined modality were attributable to the improved detection and characterization of invasive cancers, which are the cancers we are most concerned about because of their potential to metastasize," Dr. Rafferty said.
With the addition of breast tomosynthesis to standard digital mammography, false positive recall rates also significantly decreased for all 27 of the radiologists. Absolute recall rate reductions of 38.6 percent and 17.1 percent were seen in Reader Studies 1 and 2, respectively.
"In the clinical setting, we would expect that type of reduction in recall rate to translate into a substantial number of unnecessary diagnostic tests being avoided," Dr. Rafferty said.
"Assessing Radiologist Performance Using Combined Digital Mammography and Breast Tomosynthesis Compared to Digital Mammography Alone: Results of a Multicenter, Multireader Trial." Collaborating with Dr. Rafferty were Jeong Mi Park, M.D., Liane E. Philpotts, M.D., Steven P. Poplack, M.D., Jules H. Sumkin, M.D., Elkan F. Halpern, Ph.D., and Loren T. Niklason, Ph.D.
Radiology is edited by Herbert Y. Kressel, M.D., Harvard Medical School, Boston, Mass., and owned and published by the Radiological Society of North America, Inc.
RSNA is an association of more than 50,000 radiologists, radiation oncologists, medical physicists and related scientists, promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Ill.
For patient-friendly information on breast imaging, visit RadiologyInfo.org
New investigation of endovenous laser ablation of varicose veins
11.05.2016 | Kazan Federal University
A laser for your eyes
18.04.2016 | Lomonosov Moscow State University
A biological and energy-efficient process, developed and patented by the University of Innsbruck, converts nitrogen compounds in wastewater treatment facilities into harmless atmospheric nitrogen gas. This innovative technology is now being refined and marketed jointly with the United States’ DC Water and Sewer Authority (DC Water). The largest DEMON®-system in a wastewater treatment plant is currently being built in Washington, DC.
The DEMON®-system was developed and patented by the University of Innsbruck 11 years ago. Today this successful technology has been implemented in about 70...
Permanent magnets are very important for technologies of the future like electromobility and renewable energy, and rare earth elements (REE) are necessary for their manufacture. The Fraunhofer Institute for Mechanics of Materials IWM in Freiburg, Germany, has now succeeded in identifying promising approaches and materials for new permanent magnets through use of an in-house simulation process based on high-throughput screening (HTS). The team was able to improve magnetic properties this way and at the same time replaced REE with elements that are less expensive and readily available. The results were published in the online technical journal “Scientific Reports”.
The starting point for IWM researchers Wolfgang Körner, Georg Krugel, and Christian Elsässer was a neodymium-iron-nitrogen compound based on a type of...
In the Beyond EUV project, the Fraunhofer Institutes for Laser Technology ILT in Aachen and for Applied Optics and Precision Engineering IOF in Jena are developing key technologies for the manufacture of a new generation of microchips using EUV radiation at a wavelength of 6.7 nm. The resulting structures are barely thicker than single atoms, and they make it possible to produce extremely integrated circuits for such items as wearables or mind-controlled prosthetic limbs.
In 1965 Gordon Moore formulated the law that came to be named after him, which states that the complexity of integrated circuits doubles every one to two...
Characterization of high-quality material reveals important details relevant to next generation nanoelectronic devices
Quantum mechanics is the field of physics governing the behavior of things on atomic scales, where things work very differently from our everyday world.
When current comes in discrete packages: Viennese scientists unravel the quantum properties of the carbon material graphene
In 2010 the Nobel Prize in physics was awarded for the discovery of the exceptional material graphene, which consists of a single layer of carbon atoms...
24.05.2016 | Event News
20.05.2016 | Event News
19.05.2016 | Event News
27.05.2016 | Awards Funding
27.05.2016 | Life Sciences
27.05.2016 | Life Sciences