Lång Kristina, Andersson Ingvar, Rosso Aldana, Tingberg Anders, Timberg Pontus, Zackrisson Sophia
Department of Diagnostic Radiology, Translational Medicine Malmö, Lund University, Inga Marie Nilssons gata 49, SE-20502, Malmö, Sweden.
Epidemiology and Register Centre South, Skåne University Hospital, Klinikgatan 22, SE-221 85, Lund, Sweden.
Eur Radiol. 2016 Jan;26(1):184-90. doi: 10.1007/s00330-015-3803-3. Epub 2015 May 1.
To assess the performance of one-view digital breast tomosynthesis (DBT) in breast cancer screening.
The Malmö Breast Tomosynthesis Screening Trial is a prospective population-based one-arm study with a planned inclusion of 15000 participants; a random sample of women aged 40-74 years eligible for the screening programme. This is an explorative analysis of the first half of the study population (n = 7500). Participants underwent one-view DBT and two-view digital mammography (DM), with independent double reading and scoring. Primary outcome measures were detection rate, recall rate and positive predictive value (PPV). McNemar's test with 95 % confidence intervals was used.
Breast cancer was found in sixty-eight women. Of these, 46 cases were detected by both modalities, 21 by DBT alone and one by DM alone. The detection rate for one-view DBT was 8.9/1000 screens (95 % CI 6.9 to 11.3) and 6.3/1000 screens (4.6 to 8.3) for two-view DM (p < 0.0001). The recall rate after arbitration was 3.8 % (3.3 to 4.2) for DBT and 2.6 % (2.3 to 3.0) for DM (p < 0.0001). The PPV was 24 % for both DBT and DM.
Our results suggest that one-view DBT might be feasible as a stand-alone screening modality.
One-view DBT as a stand-alone breast cancer screening modality has not been investigated. One-view DBT increased the cancer detection rate significantly. The recall rate increased significantly but was still low. Breast cancer screening with one-view DBT as a stand-alone modality seems feasible.
评估单视图数字乳腺断层合成（DBT）在乳腺癌筛查中的性能。
马尔默乳腺断层合成筛查试验是一项基于人群的前瞻性单组研究，计划纳入15000名参与者；从符合筛查计划的40 - 74岁女性中随机抽样。这是对研究人群前半部分（n = 7500）的探索性分析。参与者接受了单视图DBT和双视图数字乳腺摄影（DM）检查，并进行独立的双人阅片和评分。主要结局指标为检出率、召回率和阳性预测值（PPV）。采用95%置信区间的McNemar检验。
68名女性被发现患有乳腺癌。其中，两种检查方式均检测出46例，仅DBT检测出21例，仅DM检测出1例。单视图DBT的检出率为8.9/1000次筛查（95%CI 6.9至11.3），双视图DM的检出率为6.3/1000次筛查（4.6至8.3）（p < 0.0001）。仲裁后的召回率DBT为3.8%（3.3至4.2），DM为2.6%（2.3至3.0）（p < 0.0001）。DBT和DM的PPV均为24%。
我们的结果表明，单视图DBT作为一种独立的筛查方式可能是可行的。
单视图DBT作为一种独立的乳腺癌筛查方式尚未得到研究。单视图DBT显著提高了癌症检出率。召回率显著增加但仍然较低。以单视图DBT作为独立方式进行乳腺癌筛查似乎是可行的。
