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Meta-Analysis
. 2018 Apr 3;18(1):380.
doi: 10.1186/s12885-018-4263-3.

Digital breast tomosynthesis for breast cancer screening and diagnosis in women with dense breasts - a systematic review and meta-analysis

Xuan-Anh Phi  1 , Alberto Tagliafico  2 , Nehmat Houssami  3 , Marcel J W Greuter  4 , Geertruida H de Bock  5
Affiliations
Meta-Analysis

Digital breast tomosynthesis for breast cancer screening and diagnosis in women with dense breasts - a systematic review and meta-analysis

Xuan-Anh Phi et al. BMC Cancer. .

Abstract

Background: This study aimed to systematically review and to meta-analyse the accuracy of digital breast tomosynthesis (DBT) versus digital mammography (DM) in women with mammographically dense breasts in screening and diagnosis.

Methods: Two independent reviewers identified screening or diagnostic studies reporting at least one of four outcomes (cancer detection rate-CDR, recall rate, sensitivity and specificity) for DBT and DM in women with mammographically dense breasts. Study quality was assessed using QUADAS-2. Meta-analysis of CDR and recall rate used a random effects model. Summary ROC curve summarized sensitivity and specificity.

Results: Sixteen studies were included (five diagnostic; eleven screening). In diagnosis, DBT increased sensitivity (84%-90%) versus DM alone (69%-86%) but not specificity. DBT improved CDR versus DM alone (RR: 1.16, 95% CI 1.02-1.31). In screening, DBT + DM increased CDR versus DM alone (RR: 1.33, 95% CI 1.20-1.47 for retrospective studies; RR: 1.52, 95% CI 1.08-2.11 for prospective studies). Recall rate was significantly reduced by DBT + DM in retrospective studies (RR: 0.72, 95% CI 0.64-0.80) but not in two prospective studies (RR: 1.12, 95% CI 0.76-1.63).

Conclusion: In women with mammographically dense breasts, DBT+/-DM increased CDR significantly (versus DM) in screening and diagnosis. In diagnosis, DBT+/-DM increased sensitivity but not specificity. The effect of DBT + DM on recall rate in screening dense breasts varied between studies.

Keywords: Breast density; Breast neoplasm; Digital breast tomosynthesis; Digital mammography; Meta-analysis; Review.

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Not applicable.

Competing interests

The authors declare that they have no competing interest.

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Figures

Fig. 1
Fig. 1
Flow-chart of study inclusion
Fig. 2
Fig. 2
Forest plot and Summary receiver operating characteristic plot of DBT and DM in diagnostic setting
Fig. 3
Fig. 3
Cancer detection rate of DBT and DM in diagnostic and screening studies. a In diagnostic studies. b In screening studies using two study groups. c In screening studies using one study group
Fig. 4
Fig. 4
Recall rate of DBT and DM in screening studies. a Studies used two study groups. b Studies used one study group
See this image and copyright information in PMC

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