From the July 2015 issue of HealthCare Business News magazine



HCBN: The USPSTF believes there is insufficient evidence to use tomosynthesis as a screening modality for breast cancer. What are your thoughts about that?
EAM: The JAMA trial had over 400,000 women and was a multi-center trial that showed an increased cancer detection rate and a decreased recall rate. It’s a definitive trial in my view. Additionally, it is only one of hundreds of trials that have been performed in many different countries most of which support the use of tomosynthesis. The ACR and SBI do not agree with the Task Force that there is insufficient evidence. The radiologists who perform breast imaging have quickly grasped its potential and the installed base of tomosynthesis units is increasing dramatically. I think that the Task Force is in the very, very small minority of people who think there is currently not enough evidence.


HCBN: Do you think tomosynthesis will replace 2-D mammography as a screening tool in the near future?
EAM: I see tomosynthesis eventually replacing 2-D mammography. But first of all there has to be access, which means that centers have to convert over to tomosynthesis. In addition, there has to be reimbursement for it. I personally think that there is enough evidence from the trials already to show that it’s superior over full-field digital mammography and I think most people in breast imaging feel that way. There is this feeling that maybe we need a big, randomized, controlled trial. I personally think that it would be unwise to put off a decision to embrace tomosynthesis before the results of such a trial as it will be expensive and we may have to wait a long time for results. The whole field is moving toward tomosynthesis, not only in the U.S. but in Europe as well. We need to figure out better ways to validate new technology rather than mount these types of trials.

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