Emily F. Conant, MD, didn’t mince words about the implications of the latest blockbuster mammography study:
It’s the most exciting improvement to mammography that I have seen in my career, even more important for women than the conversion from film-screen mammography to digital mammography. 3-D mammography finds more clinically significant breast cancers earlier, which is the key so that women have more treatment options and ultimately better health outcomes.
Dr. Conant is chief of breast imaging in the radiology department of the Perelman School of Medicine at the University of Pennsylvania. She was speaking about an article (of which she is senior author) published Wednesday in JAMA. She was quoted in a Penn Medicine news release.
The article described a retrospective study of 281,187 breast examinations that used digital mammography alone and 173,663 that used both digital mammography and digital breast tomosynthesis, also known as 3-D mammography.
The results were dramatic. Digital mammography and tomosynthesis combined found 41 percent more invasive cancers than digital mammography alone. Using both technologies also reduced by 15 percent the number of women called back for additional tests.
Dr. Conant is sold. She said that since October 2011, all screening mammograms at Penn Medicine’s Perelman Center for Advanced Medicine have included tomosynthesis. “The coming years will be very exciting as we see further improvements in this innovative technology,” she said. “This new technology will certainly change the way we screen women.”
Others aren’t so sure. Etta D. Pisano, MD, and Martin J. Yaffe, PhD, wrote an accompanying editorial that JAMA also published Wednesday. Dr. Pisano is dean of the College of Medicine and a professor of radiology at the Medical University of South Carolina. Dr. Yaffe is a professor of medical biophysics at the University of Toronto.
The editorial conceded that “this report adds considerable evidence to the current knowledge of how tomosynthesis performs in everyday practice.” But it criticized the design of the study and called for the National Institutes of Health to fund “an appropriately powered multisite clinical trial of modern technology” to “answer the remaining questions [about mammography] definitively.”
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To distinguish malignant breast tumors from benign ones, a new study says, four imaging parameters are better than one—or two or three. For details, see our Facebook page.
Related CME seminar (up to 22.5 AMA PRA Category 1 credits™): UCSF Breast Imaging and Digital Mammography (new release; all new material)