3D Mammography Combined with 2D Breast Exam Detects More Tumors

A Norwegian breast cancer screening trial concluded that the use of three-dimensional (3D) mammography combined with a 2D breast exam identified considerably detected more tumors than a 2D breast exam by itself.

Hologic, Inc. (Bedford, MA, USA), a developer, manufacturer, and supplier of diagnostics, medical imaging systems, and surgical products focused on serving the healthcare needs of women, reported that new study findings revealed that by adding of 3D mammography, also known as breast tomosynthesis, screening modality to a 2D breast screening scan significantly increased cancer detection while reducing the number of false-positives.

The study was led by Per Skaane, MD, PhD, from Oslo University Hospital Ullevaal (Norway). The study was based on 12,631 screening examinations in a large hospital in Norway. The researchers using Hologic’s 3D mammography technology in combination with a 2D mammogram found a significant increase in cancer detection rates, particularly for invasive cancers, and a simultaneous decrease in false-positive rates compared with 2D mammography alone. Significant findings include a 40% increase in the detection of invasive breast cancers; 27% increase in the detection of all cancers (invasive and in situ cancers combined); and, 15% decrease in false-positive rates.

The authors reported that the increase in cancer detection was found across all breast tissue densities, from dense to fatty. At the same time, there was no increase in the identification of ductal carcinoma in situ (DCIS), which is noninvasive and cited by critics of mammography screening as potentially being over-diagnosed.

As a consequence of the large increase in the detection of invasive cancers instead of in situ cancers the authors of the article, wrote, “Perhaps our most important observation is that with the mammography-plus-tomosynthesis arm, the actual benefit, in terms of possibly improving outcome owing to earlier detection, may be larger than merely the difference in the total count or number of detected cancers.”

Rob Cascella, Hologic’s president and chief executive officer, said, “A number of major papers demonstrating the value of 3D mammography have been published in the last few months. The Oslo trial is the first large-scale prospective study to show the additional cancers found with 3D mammography in combination with 2D mammography were invasive cancers—the very type of cancers we want to detect and treat early. 3D mammography is the best breast screening technology to date in that it finds significantly more invasive cancers while also reducing false positives. Most other imaging technologies for screening require users to compromise specificity [recall rate] for sensitivity [cancer detection]. We believe the value of 3D mammography in breast cancer screening is most compelling.”

3D mammography was approved for clinical use for breast cancer screening and diagnosis in the United States in February 2011 and has been available in countries recognizing the CE marking since 2008. Hologic’s 3D mammography technology is in use in 47 states and 30 countries outside the United States. Unlike a screening 2D digital mammogram, which involves a single X-ray image of the breast, 3D mammography captures multiple, low-dose images from multiple angles around the breast. The images are then used to generate a 3D reconstruction of the breast.

Dr. Per Skaane and his research team in Oslo are well known for their research. Their Oslo I and Oslo II trials were significant studies comparing 2D digital mammography to screen-film for the detection of breast cancer.

The study was published online January 2013, in advance of print, in Radiology, the Radiological Society of North America scientific journal website.

Related Links:
Hologic
Oslo University Hospital Ullevaal