Published in:
Open Access 01-11-2016 | Breast
False positives in breast cancer screening with one-view breast tomosynthesis: An analysis of findings leading to recall, work-up and biopsy rates in the Malmö Breast Tomosynthesis Screening Trial
Published in: European Radiology | Issue 11/2016
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Objectives
To analyse false positives (FPs) in breast cancer screening with tomosynthesis (BT) vs. mammography (DM).
Methods
The Malmö Breast Tomosynthesis Screening Trial (MBTST) is a prospective population-based study comparing one-view BT to DM in screening. This study is based on the first half of the MBTST population (n = 7,500). Differences in FP recall rate, findings leading to recall, work-up and biopsy rate between cases recalled on BT alone, DM alone and BT+DM were analysed.
Results
The FP recall rate was 1.7 % for BT alone (n = 131), 0.9 % for DM alone (n = 69) and 1.1 % for BT + DM (n = 81). The FP recall rate for BT alone was halved after the initial phase of the trial, stabilising at 1.5 %. BT doubled the recall of stellate distortions compared to DM (n = 64 vs. n = 33). There were fewer fibroadenomas and cysts, and the biopsy rate was slightly lower for FP recalled on BT alone compared to DM alone (15.3 % vs. 27.6 %: p = 0.037 and 33.8 % vs. 36.2 %; p = 0.641, respectively).
Conclusions
FPs increased with BT screening mainly due to the recall of stellate distortions. The FP recall rate was still well within the European guidelines and showed evidence of a learning curve. Characterisation of rounded lesions was improved with BT.
Key Points
• Tomosynthesis screening gave a higher false-positive recall rate than mammography
• There was a decline in the false-positive recall rate for tomosynthesis
• The recall due to stellate distortions simulating malignancy was doubled with tomosynthesis
• Tomosynthesis found more radial and postoperative scar tissue than mammography
• Tomosynthesis is better at characterising rounded lesions