Francesca Caumo1, Daniela Bernardi2, Stefano Ciatto3, Petra Macaskill4, Marco Pellegrini2, Silvia Brunelli1, Paola Tuttobene2, Paola Bricolo1, Carmine Fantò2, Marvi Valentini2, Stefania Montemezzi1, Nehmat Houssami5. 1. Centro di Prevenzione Senologica, Marzana, Verona, Italy. 2. U.O. Senologia Clinica e Screening Mammografico, Department of Diagnostics, Azienda Provinciale Servizi Sanitari (APSS), Trento, Italy. 3. Centro di Prevenzione Senologica, Marzana, Verona, Italy; U.O. Senologia Clinica e Screening Mammografico, Department of Diagnostics, Azienda Provinciale Servizi Sanitari (APSS), Trento, Italy. 4. Screening and Test Evaluation Program (STEP), School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia. 5. Screening and Test Evaluation Program (STEP), School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia. Electronic address: nehmath@med.usyd.edu.au.
Abstract
BACKGROUND & OBJECTIVES: Three-dimensional (3D)-mammography (tomosynthesis) may improve breast cancer detection. We examined centre-specific effect of integrated 2D/3D mammography based on the STORM (screening with tomosynthesis or standard mammography) trial. METHODS: Asymptomatic women who attended population-based screening through Trento and Verona screening centres were recruited into STORM, a prospective comparison of screen-reading in two sequential phases: 2D-mammography only and integrated 2D/3D mammography. Outcomes were the number and rates of detected cancers and of false positive recalls (FPR), and incremental cancer detection rate (CDR). Paired binary data were compared using Mc Nemar's test. RESULTS: Of 33 cancers detected in Trento, 21 were detected at both 2D and 2D/3D screening, 12 cancers were detected only with integrated 2D/3D screening compared with none detected at 2D-only screening (P < 0.001). Of the 26 cancers detected in Verona, 18 were detected at both 2D and 2D/3D screening, 8 cancers were detected only with integrated 2D/3D screening compared with none detected at 2D-only screening (P = 0.008). There were no differences between centres in baseline CDR, and incremental CDR attributable to 3D-mammography was similar for Trento (2.8/1000 screens) and for Verona (2.6/1000 screens). Trento had 239 FPR (5.7% of screens): 103 FPR at both screen-readings, 93 FPR only at 2D-mammography compared with 43 FPR only at 2D/3D-mammography (p < 0.001). Verona had 156 FPR (5.2% of screens): 78 FPR at both screen-readings, 48 FPR only at 2D-mammography compared with 30 FPR only at 2D/3D-mammography (p = 0.054). Estimated reduction in FPR proportion had recall been conditional to 2D/3D-mammography-positivity differed between centres (21.0% versus 11.5%; P = 0.02). CONCLUSION: Integrated 2D/3D-mammography significantly increased cancer detection for both screening services; potential reduction in FPR is likely to differ between centres with those experiencing relatively higher FPR most likely to benefit from 2D/3D-mammography screening.
BACKGROUND & OBJECTIVES: Three-dimensional (3D)-mammography (tomosynthesis) may improve breast cancer detection. We examined centre-specific effect of integrated 2D/3D mammography based on the STORM (screening with tomosynthesis or standard mammography) trial. METHODS: Asymptomatic women who attended population-based screening through Trento and Verona screening centres were recruited into STORM, a prospective comparison of screen-reading in two sequential phases: 2D-mammography only and integrated 2D/3D mammography. Outcomes were the number and rates of detected cancers and of false positive recalls (FPR), and incremental cancer detection rate (CDR). Paired binary data were compared using Mc Nemar's test. RESULTS: Of 33 cancers detected in Trento, 21 were detected at both 2D and 2D/3D screening, 12 cancers were detected only with integrated 2D/3D screening compared with none detected at 2D-only screening (P < 0.001). Of the 26 cancers detected in Verona, 18 were detected at both 2D and 2D/3D screening, 8 cancers were detected only with integrated 2D/3D screening compared with none detected at 2D-only screening (P = 0.008). There were no differences between centres in baseline CDR, and incremental CDR attributable to 3D-mammography was similar for Trento (2.8/1000 screens) and for Verona (2.6/1000 screens). Trento had 239 FPR (5.7% of screens): 103 FPR at both screen-readings, 93 FPR only at 2D-mammography compared with 43 FPR only at 2D/3D-mammography (p < 0.001). Verona had 156 FPR (5.2% of screens): 78 FPR at both screen-readings, 48 FPR only at 2D-mammography compared with 30 FPR only at 2D/3D-mammography (p = 0.054). Estimated reduction in FPR proportion had recall been conditional to 2D/3D-mammography-positivity differed between centres (21.0% versus 11.5%; P = 0.02). CONCLUSION: Integrated 2D/3D-mammography significantly increased cancer detection for both screening services; potential reduction in FPR is likely to differ between centres with those experiencing relatively higher FPR most likely to benefit from 2D/3D-mammography screening.
Authors: Achim Wöckel; Jasmin Festl; Tanja Stüber; Katharina Brust; Stephanie Stangl; Peter U Heuschmann; Ute-Susann Albert; Wilfried Budach; Markus Follmann; Wolfgang Janni; Ina Kopp; Rolf Kreienberg; Thorsten Kühn; Thomas Langer; Monika Nothacker; Anton Scharl; Ingrid Schreer; Hartmut Link; Jutta Engel; Tanja Fehm; Joachim Weis; Anja Welt; Anke Steckelberg; Petra Feyer; Klaus König; Andrea Hahne; Hans H Kreipe; Wolfram Trudo Knoefel; Michael Denkinger; Sara Brucker; Diana Lüftner; Christian Kubisch; Christina Gerlach; Annette Lebeau; Friederike Siedentopf; Cordula Petersen; Hans Helge Bartsch; Rüdiger Schulz-Wendtland; Markus Hahn; Volker Hanf; Markus Müller-Schimpfle; Ulla Henscher; Renza Roncarati; Alexander Katalinic; Christoph Heitmann; Christoph Honegger; Kerstin Paradies; Vesna Bjelic-Radisic; Friedrich Degenhardt; Frederik Wenz; Oliver Rick; Dieter Hölzel; Matthias Zaiss; Gudrun Kemper; Volker Budach; Carsten Denkert; Bernd Gerber; Hans Tesch; Susanne Hirsmüller; Hans-Peter Sinn; Jürgen Dunst; Karsten Münstedt; Ulrich Bick; Eva Fallenberg; Reina Tholen; Roswita Hung; Freerk Baumann; Matthias W Beckmann; Jens Blohmer; Peter A Fasching; Michael P Lux; Nadia Harbeck; Peyman Hadji; Hans Hauner; Sylvia Heywang-Köbrunner; Jens Huober; Jutta Hübner; Christian Jackisch; Sibylle Loibl; Hans-Jürgen Lück; Gunter von Minckwitz; Volker Möbus; Volkmar Müller; Ute Nöthlings; Marcus Schmidt; Rita Schmutzler; Andreas Schneeweiss; Florian Schütz; Elmar Stickeler; Christoph Thomssen; Michael Untch; Simone Wesselmann; Arno Bücker; Mathias Krockenberger Journal: Geburtshilfe Frauenheilkd Date: 2018-10-19 Impact factor: 2.915