by
Lauren Dubinsky, Senior Reporter | July 02, 2015
From the July 2015 issue of HealthCare Business News magazine
Last June, a study was published in the Journal of the American Medical Association that compared 281,187 traditional mammography exams with 173,663 tomosynthesis exams using Hologic’s system. It found that tomosynthesis is associated with a 41 percent increase in the detection of invasive breast cancers and a 29 percent increase in the detection of all breast cancers. It also revealed that tomosynthesis reduces the number of women recalled for additional imaging by 15 percent.
A recent study conducted by Lund University in Sweden that involved 7,500 women between the ages of 40 and 74, found that tomosynthesis detects 40 percent more breast cancers than traditional 2-D mammography. Kopans has little doubt that tomosynthesis will replace 2-D mammography for screening in the next few years. He believes that the major impediment is the fact that the USPSTF consists of individuals without breast cancer expertise.
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USPSTF’s draft guidelines, which were issued in April, suggested that tomosynthesis is not ready to be used as an adjunctive screening test. “The only way for [tomosynthesis] to find more early cancers is to use it for screening,” Kopans wrote. “The only way for [tomosynthesis] to reduce recall rates is to use it for screening.“
But even though tomosynthesis has many benefits over 2-D mammography, both Zuley and Kopans agree that it is not a perfect test. “I think that tomosynthesis is an incremental step in the right direction, in that we are reducing harms and improving the benefits, but it is not a giant leap forward,” says Zuley.
In the same way that 2-D mammography screening doesn’t find all cancers and doesn’t find all cancers early enough, tomosynthesis is not going to put an end to all breast cancer deaths, wrote Kopans. He does believe that tomosynthesis will drive down the death rate but that other modalities including ultrasound and MRI will need to be used in conjunction with it to maximize cancer detection.
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Davis Graham
3-D versus breast MRI
July 10, 2015 07:00
Tomosynthesis continues to compare itself to 2-D mammography. The true comparison is with breast MRI, no radiation, easier for the radiologist to read and most physicians say breast MRI is the gold standard.
My suggestion for price point and quality is for Lauren Dubinsky and Dotmed team is to make the comparison of Tomosynthesis to an MRI of the Breast, instead of looking in the rearview mirror of old technology in mammography. It is not technology we need to look at, as much as it is what is best for the patient. And the price point is very comparable when looking at the expense of the machines.
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Lauren Dubinsky
re: 3-D versus breast MRI
July 13, 2015 10:24
Hi Davis,
Thanks for your comment. A comparison of tomosynthesis and breast MRI would be very interesting. I'm going to look into that. We published an article about supplemental breast MRI for women with dense breasts on Friday. Maybe that would be something of interest to you. Here's the link: https://www.dotmed.com/news/story/26287
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