Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Radiography (Lond). 2023 Oct;29(6):975-979. doi: 10.1016/j.radi.2023.07.001. Epub 2023 Aug 11.
The purpose of our study was to compare the performance of 2D (FFDM) against 3D (FFDM plus DBT) examinations in the post-treatment surveillance of asymptomatic breast cancer survivors.
A list of women with a history of breast cancer who underwent screening mammography (2D or 3D) from 5/2017 to 5/2020 was retrieved. A total of 20,210 examinations were identified and performance metrics were compared.
There were no statistically significant difference in cancer detection rate (CDR) (p = 0.38), recall rate (RR) (p = 0.087), or positive predictive value (PPV) (p = 0.74) between 2D vs. 3D examinations. Stratification by breast tissue identified no statistically significant difference in CDR (p = 0.581 and p = 0.428), RR (p = 0.230 and p = 0.205), or PPV (p = 0.908 and p = 0.721) between fatty/scattered and heterogeneous/extremely dense breast tissue when comparing 2D vs 3D examinations. Stratification by age did not identify a significant difference in RR or PPV between the two groups. CDR was statistically increased with 2D vs. 3D examinations in the 60-69 years group (p = 0.021). Stratification by race did not identify a significant difference in RR or PPV between the two groups. CDR was statistically increased with 3D vs. 2D examinations in white women (p = 0.036). Stratification by laterality (bilateral vs. unilateral post mastectomy) did not identify a significant difference in RR or PPV between the two groups. CDR was statistically increased in 2D vs. 3D examinations in unilateral studies (p = 0.009).
For asymptomatic women with a history of breast cancer, there is no evidence that the addition of DBT to FFDM improves CDR, RR, or PPV.
More studies are needed concerning screening methodologies supplementing FFDM in the screening regimens of breast cancer survivors.
本研究的目的是比较二维（FFDM）与三维（FFDM 加 DBT）检查在无症状乳腺癌幸存者治疗后监测中的表现。
检索了 2017 年 5 月至 2020 年 5 月间接受筛查乳房 X 线摄影（二维或三维）的有乳腺癌病史的女性名单。共确定了 20210 次检查，并比较了性能指标。
在癌症检出率（CDR）（p=0.38）、召回率（RR）（p=0.087）和阳性预测值（PPV）（p=0.74）方面，二维与三维检查之间无统计学差异。按乳腺组织分层，在 CDR（p=0.581 和 p=0.428）、RR（p=0.230 和 p=0.205）或 PPV（p=0.908 和 p=0.721）方面，脂肪/散在和异质/极度致密乳腺组织的二维与三维检查之间也无统计学差异。按年龄分层，两组间 RR 或 PPV 无显著差异。与 3D 相比，60-69 岁组的 2D 检查 CDR 统计学上增加（p=0.021）。按种族分层，两组间 RR 或 PPV 无显著差异。与 2D 相比，白人女性的 3D 检查 CDR 统计学上增加（p=0.036）。按侧别（双侧与单侧乳房切除术）分层，两组间 RR 或 PPV 无显著差异。单侧研究中 2D 检查的 CDR 统计学上高于 3D 检查（p=0.009）。
对于有乳腺癌病史的无症状女性，没有证据表明在 FFDM 中添加 DBT 可提高 CDR、RR 或 PPV。
需要进一步研究补充 FFDM 的筛查方法在乳腺癌幸存者的筛查方案中的应用。
