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Multicenter Study
. 2018 Nov;211(5):957-963.
doi: 10.2214/AJR.17.19350. Epub 2018 Sep 20.

The Effect of Digital Breast Tomosynthesis Adoption on Facility-Level Breast Cancer Screening Volume

Christoph I Lee  1   2   3   4   5   6   7   8   9   10 , Weiwei Zhu  1   2   3   4   5   6   7   8   9   10 , Tracy L Onega  1   2   3   4   5   6   7   8   9   10 , Jessica Germino  1   2   3   4   5   6   7   8   9   10 , Ellen S O'Meara  1   2   3   4   5   6   7   8   9   10 , Constance D Lehman  1   2   3   4   5   6   7   8   9   10 , Louise M Henderson  1   2   3   4   5   6   7   8   9   10 , Jennifer S Haas  1   2   3   4   5   6   7   8   9   10 , Karla Kerlikowske  1   2   3   4   5   6   7   8   9   10 , Brian L Sprague  1   2   3   4   5   6   7   8   9   10 , Garth H Rauscher  1   2   3   4   5   6   7   8   9   10 , Anna N A Tosteson  1   2   3   4   5   6   7   8   9   10 , Jennifer Alford-Teaster  1   2   3   4   5   6   7   8   9   10 , Karen J Wernli  1   2   3   4   5   6   7   8   9   10 , Diana L Miglioretti  1   2   3   4   5   6   7   8   9   10
Affiliations
Multicenter Study

The Effect of Digital Breast Tomosynthesis Adoption on Facility-Level Breast Cancer Screening Volume

Christoph I Lee et al. AJR Am J Roentgenol. 2018 Nov.

Abstract

Objective: The purpose of this study was to determine whether digital breast tomosynthesis (DBT) adoption was associated with a decrease in screening mammography capacity across Breast Cancer Screening Consortium facilities, given concerns about increasing imaging and interpretation times associated with DBT.

Subjects and methods: Facility characteristics and examination volume data were collected prospectively from Breast Cancer Screening Consortium facilities that adopted DBT between 2011 and 2014. Interrupted time series analyses using Poisson regression models in which facility was considered a random effect were used to evaluate differences between monthly screening volumes during the 12-month preadoption period and the 12-month postadoption period (with the two periods separated by a 3-month lag) and to test for changes in month-to-month facility-level screening volume during the preadoption and postadoption periods.

Results: Across five regional breast imaging registries, 15 of 83 facilities (18.1%) adopted DBT for screening between 2011 and 2014. Most had no academic affiliation (73.3% [11/15]), were nonprofit (80.0% [12/15]), and were general radiology practices (66.7% [10/15]). Facility-level monthly screening volumes were slightly higher during the postadoption versus preadoption periods (relative risk [RR], 1.09; 95% CI, 1.06-1.11). Monthly screening volumes remained relatively stable within the preadoption period (RR, 1.00 per month; 95% CI 1.00-1.01 per month) and the postadoption period (RR, 1.00; 95% CI, 1.00-1.01 per month).

Conclusion: In a cohort of facilities with varied characteristics, monthly screening examination volumes did not decrease after DBT adoption.

Keywords: breast cancer screening; capacity; digital breast tomosynthesis; technology adoption.

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Conflict of interest statement

Conflicts of Interest: All authors report no conflicts of interests related to this work. Drs. Lee and Lehman report grant funding from GE Healthcare unrelated to this work.

Figures

Figure 1.
Figure 1.. Monthly Screening Volume Trends Pre- and Post-Tomosynthesis Adoption
Monthly screening volumes for each facility are plotted with dashed lines. The overall combined average is demonstrated as a solid black line. The vertical lines represent the adoption (lag) period (three months) for digital breast tomosynthesis.
Figure 2.
Figure 2.. Monthly Facility-Level Screening Tomosynthesis Percentages Post-Adoption
Monthly percentage of screening exams that were digital breast tomosynthesis for each facility are plotted with dashed lines. The overall combined average is demonstrated as a solid black line. The vertical lines represent the end of adoption (lag) period (three months) for digital breast tomosynthesis.
Figure 3.
Figure 3.. Monthly Diagnostic Volume Trends Pre- and Post-Tomosynthesis Adoption
Monthly diagnostic volumes for each facility are plotted with dashed lines. The overall combined average is demonstrated as a solid black line. The vertical lines represent the adoption (lag) period (three months) for digital breast tomosynthesis.
See this image and copyright information in PMC

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