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Portrait of Predrag Bakic. Photo

Predrag Bakic

Associate Professor

Portrait of Predrag Bakic. Photo

Assessing Digital Breast Tomosynthesis Impact on Early Cancer Detection : Insights from Consecutive Screening

Author

  • Annika Jögi
  • Kristin Johnson
  • Sofia Wittgren
  • Victor Sundgren
  • Hanna Tomic
  • Jakob Olinder
  • Anna Åkesson
  • Ingvar Andersson
  • Sophia Zackrisson
  • Predrag R. Bakic

Summary, in English

Background: Analysis of how digital breast tomosynthesis (DBT) screening affects consecutive screening performance is important to estimate its future value in screening. Purpose: To evaluate whether DBT contributes to early detection of breast cancer by assessing cancer detection rates (CDRs), including the fraction of invasive cancers and cancer subtypes in consecutive routine digital mammography (DM). Materials and Methods: The paired prospective Malmö Breast Tomosynthesis Screening Trial (MBTST) was performed between January 2010 and February 2015. Participating women underwent one-view DBT and two-view DM at one screening occasion. In this secondary analysis, women were followed up through their first (DM1) and second (DM2) consecutive two-view DM screening rounds after MBTST participation. Cancer diagnoses were identified by referencing records. A logistic regression model, adjusted for age, was used to calculate the odds of luminal A-like cancers with use of the MBTST as reference. Results: There were 14 848 final participants in the MBTST (median age, 57 years [IQR, 49-65 years]). Of those, 12 876 women were screened in DM1 (median age, 58 years [IQR, 50-66 years]) and 10 883 were screened in DM2 (median age, 59 years [IQR, 51-67 years]). Compared with CDRs in the trial of 6.5 of 1000 women (95% CI: 5.2, 7.9) for DM and 8.7 of 1000 women (95% CI: 7.3, 10.3) for DBT, the CDR was lower in DM1 (4.6 of 1000 women [95% CI: 3.6, 5.9]) and DM2 (5.3 of 1000 women [95% CI: 4.1, 6.9]). The proportion of invasive cancers was 84.9% (118 of 139 cancers) in the MBTST; the corresponding numbers were 66% (39 of 59 cancers) for DM1 and 83% (50 of 60 cancers) for DM2. The odds of luminal A-like cancers were lower in DM1 at 0.28 (95% CI: 0.12, 0.66 [P = .004]) but not in DM2 at 0.80 (95% CI: 0.40, 1.58 [P = .52]) versus screening in the MBTST. Conclusion: CDR and the fraction of invasive cancers were lower in DM1 and then increased in DM2 following the MBTST, indicating earlier cancer detection mainly due to increased detection of luminal A-like cancers in DBT screening.

Department/s

  • Division of Translational Cancer Research
  • LUCC: Lund University Cancer Centre
  • Tumor Cell Biology
  • Radiology Diagnostics, Malmö
  • Medical Radiation Physics, Malmö
  • EpiHealth: Epidemiology for Health
  • LTH Profile Area: Photon Science and Technology
  • LU Profile Area: Light and Materials

Publishing year

2024-07

Language

English

Publication/Series

Radiology

Volume

312

Issue

1

Document type

Journal article

Publisher

Radiological Society of North America

Topic

  • Cancer and Oncology

Status

Published

Research group

  • Tumor Cell Biology
  • Radiology Diagnostics, Malmö
  • Medical Radiation Physics, Malmö

ISBN/ISSN/Other

  • ISSN: 0033-8419