Differences in Diagnostic Workup Pathways for Abnormal Breast Cancer Screenings

Strategic Insights -

A new study comparing digital mammography and digital breast tomosynthesis screenings has revealed differences in the diagnostic workup pathways for abnormal results. Researchers found that the number of imaging modalities in the diagnostic pathway was similar for both types of screenings, but the first workup procedure was more often ultrasound after abnormal results on digital breast tomosynthesis compared to digital mammography. Additionally, biopsy rates were higher for digital breast tomosynthesis versus digital mammography, with a greater likelihood of surgical biopsies.

Key Takeaways:

  • The study included 77,123 digital breast tomosynthesis and 197,589 digital mammography screenings with abnormal results from 2011 to 2020 at 107 facilities across six Breast Cancer Surveillance Consortium registries.
  • The first workup procedure after abnormal results on digital breast tomosynthesis was more often ultrasound (21.1%) compared to digital mammography (4.7%).
  • Biopsy rates were higher for digital breast tomosynthesis (16.2%) versus digital mammography (14.0%), with biopsies after digital mammography more likely to be surgical (5.8% versus 3.2%).
  • The rate of excision biopsy per 1,000 screens with abnormal findings was 5.1 for digital breast tomosynthesis and 8.0 for digital mammography.
  • Time to diagnostic resolution was similar for both screenings, with a median of 10 days.

Statistics:

  • 77,123 digital breast tomosynthesis screenings with abnormal results (Source: Study)
  • 197,589 digital mammography screenings with abnormal results (Source: Study)
  • 21.1% of abnormal results on digital breast tomosynthesis were followed by an ultrasound workup (Source: Study)
  • 4.7% of abnormal results on digital mammography were followed by an ultrasound workup (Source: Study)
  • 16.2% of abnormal results on digital breast tomosynthesis were followed by a biopsy (Source: Study)
  • 14.0% of abnormal results on digital mammography were followed by a biopsy (Source: Study)
  • 5.1 excision biopsies per 1,000 screens with abnormal findings on digital breast tomosynthesis (Source: Study)
  • 8.0 excision biopsies per 1,000 screens with abnormal findings on digital mammography (Source: Study)
  • Median time to diagnostic resolution: 10 days (Source: Study)

Sources:

  • Journal of the American College of Radiology
  • NIH National Cancer Institute (NCI)
  • NIH National Institute of General Medical Sciences (NIGMS)
  • University of the North
  • Louise M. Henderson, University of the North Carolina, Dept. of Radiology
  • Weiwei Zhu, Erin J. Aiello Bowles, Tracy Onega, Karla Kerlikowske, Diana L. Miglioretti, Brian L. Sprague, Donald L. Weaver, Anna N. A. Tosteson, and Christoph I. Lee.