Martha T Manda-Mapalo1, Stephanie G Fine2, Sarah Safadi3, Ji-Hyun Lee4, Ruofei Du5,6, Andrew L Sussman7, Shiraz Mishra8, Reed G Selwyn9, Jennifer L Saline9, Wendy L Hine10, Ursa A Brown-Glaberman1. 1. Division of Hematology/Oncology, MSC 07-4025, University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico, USA. 2. Division of Surgical Oncology, University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico, USA. 3. Division of Gastroenterology, Hepatology and Nutrition, University of Louisville, Louisville, Kentucky, USA. 4. Division of Quantitative Sciences at the UF Health Cancer Center, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, Florida, USA. 5. Department of Internal Medicine, Biostatistics Shared Resource, University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico, USA. 6. Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA. 7. Department of Family and Community Medicine, University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico, USA. 8. Department of Pediatrics and UNM Comprehensive Cancer Center, University of New Mexico Health Sciences Center, MSC 10 5590, 1 University of New Mexico, Albuquerque, New Mexico, USA. 9. Department of Radiology, MSC 10 5530, 1 University of New Mexico, Albuquerque, New Mexico, USA. 10. University of New Mexico Hospital, Albuquerque, New Mexico, USA.
Abstract
Introduction: Digital breast tomosynthesis (DBT) may decrease recall rates (RRs) and improve positive predictive values (PPVs) and cancer detection rates (CDRs) versus full-field digital mammography (FFDM). The value of DBT has not been assessed in New Mexico's rural and minority population. Objectives of this study were to compare RRs, CDRs, and PPVs using FFDM+DBT versus FFDM in screening mammograms at the University of New Mexico between 2013 and 2016 and to qualitatively evaluate patient decision-making regarding DBT. Materials and Methods: RRs, CDRs, and PPVs with 95% confidence intervals and relative risk were calculated from 35,147 mammograms. The association between relative risk and mammography approach was tested using Pearson's chi-square test. Twenty women undergoing screening were interviewed for qualitative evaluation of decision-making. Results: From 2013 to 2016, RRs were 8.4% and 11.1% for FFDM+DBT and FFDM, respectively. The difference in RRs became more pronounced with time. No significant difference was observed in PPVs or CDRs. Qualitative interviews revealed that the majority had limited prior knowledge of DBT and relied on provider recommendations. Conclusion: In New Mexico women undergoing screening mammography, a 30% relative risk reduction in RRs was observed with FFDM+DBT. Qualitative interviews suggest that women are aware of and receptive to DBT, assuming adequate educational support. Clinical Trials.gov ID: NCT03979729.
Introduction: Digital breast tomosynthesis (DBT) may decrease recall rates (RRs) and improve positive predictive values (PPVs) and cancer detection rates (CDRs) versus full-field digital mammography (FFDM). The value of DBT has not been assessed in New Mexico's rural and minority population. Objectives of this study were to compare RRs, CDRs, and PPVs using FFDM+DBT versus FFDM in screening mammograms at the University of New Mexico between 2013 and 2016 and to qualitatively evaluate patient decision-making regarding DBT. Materials and Methods: RRs, CDRs, and PPVs with 95% confidence intervals and relative risk were calculated from 35,147 mammograms. The association between relative risk and mammography approach was tested using Pearson's chi-square test. Twenty women undergoing screening were interviewed for qualitative evaluation of decision-making. Results: From 2013 to 2016, RRs were 8.4% and 11.1% for FFDM+DBT and FFDM, respectively. The difference in RRs became more pronounced with time. No significant difference was observed in PPVs or CDRs. Qualitative interviews revealed that the majority had limited prior knowledge of DBT and relied on provider recommendations. Conclusion: In New Mexico women undergoing screening mammography, a 30% relative risk reduction in RRs was observed with FFDM+DBT. Qualitative interviews suggest that women are aware of and receptive to DBT, assuming adequate educational support. Clinical Trials.gov ID: NCT03979729.
Entities:
Keywords:
breast cancer screening; digital breast tomosynthesis; medically underserved women; recall rate
Authors: Per Skaane; Sofie Sebuødegård; Andriy I Bandos; David Gur; Bjørn Helge Østerås; Randi Gullien; Solveig Hofvind Journal: Breast Cancer Res Treat Date: 2018-02-10 Impact factor: 4.872