JAMA: Adding 3-D mammography decreases patient recalls, increases cancer detection

Selenia Dimensions mammography system--Courtesy of Hologic

Improving the accuracy of breast exams to detect cancer is at the forefront of research agendas since, in recent years, the necessity of routine screening--as well as vigorous surgical and radiation protocols--have been called into question.

A letter in the April 26 issue of The Journal of the American Medical Association (JAMA) presents data indicating that 3-D mammography (or tomosynthesis), when added to standard digital mammography, can result in fewer patients being recalled for follow-up and more accurate cancer diagnosis.

The study used Genius 3D Mammography technology from Hologic ($HOLX). It found that the results applied also to women with dense breast tissue, who are considered notoriously difficult to image accurately for cancer detection.

"Utilizing Genius 3D Mammography exams for breast cancer screening will reduce the need for subsequent unnecessary testing, and decrease the number of unnecessary breast biopsies--addressing concerns that were previously raised as limitations of conventional mammography while also reducing costs for health systems," said Pete Valenti, Hologic Division President, Breast and Skeletal Health Solutions, in a statement.

"Twenty-six states have passed legislation requiring doctors to notify women if they have dense breasts--and now these women who were previously confused about how to proceed with breast cancer screening can feel confident turning to 3D Mammography exams to reduce their chances of stressful recalls and help find more invasive cancer," he added.

The results included 452,320 breast exams. Of these, 278,906 included standard digital mammography alone, while another 173,414 included both tomography and digital mammography. In total, 2,157 breast cancer cases were detected.

The inclusion of tomography reduced the recall rate per 1,000 patients for reexamination from 90 to 79 in women with nondense breasts and from 127 to 109 in women with dense breasts. It also improved the cancer detection rate per 1,000 patients from 3 to 4 women with nondense breasts and from 2.9 to 4.2 in women with dense breasts.

"Density creates challenges for conventional mammography by obscuring the images, which often results in additional visits and exams for women," said Hologic Medical Director Dr. Edward Evantash. "This new analysis confirms that Genius 3D Mammography exams reduce unnecessary follow-up exams in dense-breasted women. This has the potential to provide health systems and insurance companies with significant cost savings, reduce patient stress and expenses, and alleviate challenges for referring physicians who are tasked with relaying mammography results to their patients."

- here is the Hologic announcement
- and here is the JAMA letter