Early detection of breast cancer has taken a decisive step forward, as a new publication from the Cordoba Tomosynthesis Screening Trial (CBTST)1 shows. The research focused on the effects of digital breast tomosynthesis (DBT) in combination with digital mammography (DM) on interval cancer rates in women.
Background: The Cordoba Tomosynthesis Screening Trial has already shown in previous publications that tomosynthesis with a single reader achieves better results than mammography with double reports. The current study focuses on interval cancer rates (ICR) and on women with dense breast tissue.
Study design: The prospective study, conducted from January 2015 to December 2016, included 39,855 women. In one arm, sequential reading was performed, first with DM and then using DBT+DM, while in the control arm only DM was used.
Results: The outstanding finding of the study is the significant reduction in interval cancer rates in women screened with DBT+DM compared to those screened with DM alone. The differences were particularly impressive in women with dense breast tissue.
All breast densities (ACR A+B+C+D): A significant reduction in the interval cancer rate of 48% was observed (from 1.8 to 0.93 per 1000).
Dense breast tissue (defined as ACR C+D): This even showed a significant reduction of 70% (from 3.17 to 0.95 per 1000).
The average tumor size in interval cancers was also reduced, from 27 mm (+/- 3 mm) to 15 mm (+/- 2 mm), which represents another positive aspect of the DBT+DM screening method.
Implications and Outlook: These results highlight the effectiveness of digital breast tomosynthesis in early breast cancer detection, particularly in women with dense breast tissue. Reducing interval cancer rates and shrinking tumor size are promising developments that have the potential to improve the effectiveness of breast cancer screening programs.
Overall, this study provides important insight into the advances in early detection technologies and highlights the importance of a holistic approach to women’s breast health. Further research and implementation of such advanced screening methods could make a significant contribution to reducing breast cancer incidence and mortality.
Dr. Alexander Hoffmann, Director Market Access EU North at Hologic Deutschland GmbH, comments on the study: “The promising results of the interval cancer rates are extremely encouraging. However, it is essential to also wait for the results of the German ToSyMa study on interval cancer. This study offers a more realistic scenario as it examines the combination of tomosynthesis with synthetic 2D mammography (DBT + S2D) – in contrast to the Spanish study, in which women were examined with both tomosynthesis and digital mammography. The future findings can make a significant contribution to the further development of our screening technologies and to the optimization of early breast cancer detection.”
Referenzen: 1. Pulido-Carmona C, Romero-Martín S, Raya-Povedano JL, et al. Interval cancer in the Córdoba Breast Tomosynthesis Screening Trial (CBTST): comparison of digital breast tomosynthesis plus digital mammography to digital mammography alone. European Radiology. 2024; Published online. doi:10.1007/s00330-023-10546-x
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