Breast tomosynthesis after screening mammography reduces need for ultrasound, biopsies

Breast tomosynthesis in the diagnostic workup for one- or two-view focal asymmetry detected at screening mammography resulted in less use of ultrasound, fewer biopsies, and higher positive predictive value for cancer than when diagnostic exams involved only 2D mammography, according to a study conducted at the University of Virginia.

"Tomosynthesis has been evaluated in screening populations and been shown to decrease recall rates," said researcher Brandi Nicholson, "but studies in the diagnostic setting are lacking."

Five hundred thirty two patients who were recalled for a focal asymmetric density discovered at screening were analyzed across three categories: women recalled prior to the availability of tomosynthesis in the practice (PT), those who did not have tomosynthesis at diagnostic evaluation after it was available (NT), and those who had diagnostic tomosynthesis (YT). There were 238 patients in the PT group, 145 in the NT group, and 149 in the YT group.

The researchers found that additional full views and ultrasound were performed significantly less frequently in the YT group than in both the PT and NT groups. They also found that the PPV was increased for the YT group compared to both the PT and NT groups.