Initial Experience With Digital Tomosynthesis In Screening Mammography

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Images of the entire breast can be captured regardless of tissue density.

Screening mammography aims to reduce morbidity and mortality from breast cancer by early detection and treatment of occult malignancies.

There is extensive evidence from a variety of well-conducted, randomized controlled studies that annual or biennial mammography is effective in reducing breast cancer mortality by 30 % in women aged 50 to 69 years. Results from the Canadian National Breast Screening Study (CNBSS) suggest that the contribution of mammography over good physical examinations to breast cancer mortality reduction may be less than has been assumed.

This observation re-emphasizes a truism of screening -- that it is not necessary to detect cancers as early as possible to obtain a benefit -- it is only necessary to detect them early enough.

The American Medical Association (AMA), the Society of Breast Imaging (SBI), the American College of Radiology (ACR), and the American Cancer Society (ACS), all support screening with mammography and CBE beginning at age 40.

Recent recommendations from the SBI and the ACR (2010) released after the 2009 USPSTF recommendations, which recommended that average-risk women wait until age 50 to undergo screening mammography, continue to support yearly screening mammography beginning at age 40 for women at average-risk for breast cancer.

It is also excellent in helping identify small suspicious lesions of 10 mm or less.

However, ultrasound should always be performed in addition to tomosynthesis as lesions may rarely be downgraded.

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