Section for Breast Cancer Screening, Cancer Registry of Norway, Oslo, Norway.
Department of Radiology, University of Washington School of Medicine, Seattle, WA, USA; Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA.
Eur J Radiol. 2023 Oct;167:111069. doi: 10.1016/j.ejrad.2023.111069. Epub 2023 Sep 1.
To describe and compare early screening outcomes before, during and after a randomized controlled trial with digital breast tomosynthesis (DBT) including synthetic 2D mammography versus standard digital mammography (DM) (To-Be 1) and a follow-up cohort study using DBT (To-Be 2).
Retrospective results of 125,020 screening examinations from four consecutive screening rounds performed in 2014-2021 were described and compared for pre-To-Be 1 (DM), To-Be 1 (DM or DBT), To-Be 2 (DBT), and post-To-Be 2 (DM) cohorts. Descriptive analyses of rates of recall, biopsy, screen-detected and interval cancer, distribution of histopathologic tumor characteristics and time spent on image interpretation and consensus were presented for the four rounds including five cohorts, one cohort in each screening round except for the To-Be 1 trail, which included a DBT and a DM cohort. Odds ratios (OR) with 95% CIs was calculated for recall and cancer detection rates.
Rate of screen-detected cancer was 0.90% for women screened with DBT in To-Be 2 and 0.64% for DM in pre-To-Be 1. The rates did not differ for the To-Be 1 DM (0.61%), To-Be 1 DBT (0.66%) and post-To-Be 2 DM (0.67%) cohorts. The interval cancer rates ranged between 0.13% and 0.20%. The distribution of histopathologic tumor characteristics did not differ between the cohorts.
Screening all women with DBT following a randomized controlled trial in an organized, population-based screening program showed a temporary increase in the rate of screen-detected cancer.
描述并比较在一项数字乳腺断层合成摄影术（DBT）与标准数字乳腺摄影术（DM）（To-Be 1）的随机对照试验之前、期间和之后的早期筛查结果，以及使用 DBT 的随访队列研究（To-Be 2）。
回顾性分析了 2014 年至 2021 年连续四次筛查中 125020 例筛查检查的结果，比较了 To-Be 1（DM）、To-Be 1（DM 或 DBT）、To-Be 2（DBT）和 To-Be 2（DM）队列的结果。对四个筛查轮次包括五个队列（除了 To-Be 1 试验，该试验包括 DBT 和 DM 队列）的五个队列的召回率、活检率、筛查检出癌和间隔癌、组织病理学肿瘤特征分布以及图像解读和共识所花费的时间进行描述性分析。计算了召回率和癌症检出率的比值比（OR）和 95%可信区间（CI）。
在 To-Be 2 中，接受 DBT 筛查的女性中筛查检出癌的比例为 0.90%，而在 pre-To-Be 1 中为 0.64%。To-Be 1 DM（0.61%）、To-Be 1 DBT（0.66%）和 post-To-Be 2 DM（0.67%）队列的比例没有差异。间隔癌的比例在 0.13%至 0.20%之间。队列之间组织病理学肿瘤特征的分布没有差异。
在一项有组织的、基于人群的筛查计划中，对所有女性进行 DBT 筛查后，随机对照试验显示筛查检出癌的比例暂时增加。
