Tokyo Health Service Association, Tokyo, Japan.
St Luke's International Hospital, Tokyo, Japan.
Breast Cancer. 2022 Sep;29(5):790-795. doi: 10.1007/s12282-022-01358-w. Epub 2022 May 18.
There are few studies have conducted digital breast tomosynthesis (DBT) in addition to digital mammography (2DDM) and ultrasound (US) for screening. The purpose of this study is to determine the possibility of synergistic effects of DBT and US screening for Japanese.
5023 examinations of the opportunistic screening using 2DDM and US (2D group: 2581) or 2DDM and US plus DBT (3 group: 2442) were performed at our facility from May 1, 2017 to March 31, 2019. This study was not RCT, and the backgrounds of the two groups were different.
The recall rate was 3.1% in the 2D group and 2.6% for the 3D group (p = 0.27). The number of detected cancer cases was 6 (0.23%) in the 2D group and 12 (0.49%) in the 3D group (p = 0.16). The positive predictive value (PPV) was 7.4% for the 2D group and 19.0% for the 3D group (p = 0.045). There was one invasive ductal carcinoma case which had no findings in 2DDM and US, but had a slight distortion in the images of DBT.
We examined and reported whether DBT was useful for breast cancer screening combined with mammography and US. Compared to the 2D group, the 3D group showed better results of PPV with significant difference. However, due to the non-randomized design and difference between the two groups, the results should be interpreted in caution. Adding DBT in 2DDM and US screening would be acceptable only if the benefits and disadvantages are explained to the women undergoing the screening.
很少有研究在数字乳腺断层摄影术（DBT）之外，还结合数字乳腺 X 线摄影术（2DDM）和超声（US）进行筛查。本研究的目的是确定 DBT 和 US 筛查对日本人的协同作用的可能性。
2017 年 5 月 1 日至 2019 年 3 月 31 日，我们机构对 5023 例机会性筛查进行了 2DDM 和 US（2D 组：2581 例）或 2DDM 和 US 加 DBT（3 组：2442 例）的检查。本研究不是 RCT，两组的背景不同。
2D 组的召回率为 3.1%，3D 组为 2.6%（p=0.27）。2D 组发现 6 例（0.23%）癌病例，3D 组发现 12 例（0.49%）（p=0.16）。2D 组的阳性预测值（PPV）为 7.4%，3D 组为 19.0%（p=0.045）。有 1 例浸润性导管癌病例在 2DDM 和 US 中均未见异常，但在 DBT 图像中显示轻微扭曲。
我们检查并报告了 DBT 对结合乳腺 X 线摄影术和 US 的乳腺癌筛查是否有用。与 2D 组相比，3D 组的 PPV 结果更好，差异有统计学意义。然而，由于非随机设计和两组之间的差异，结果应谨慎解释。只有在向接受筛查的女性解释了利弊，在 2DDM 和 US 筛查中增加 DBT 才是可以接受的。
