False positives in breast cancer screening with one-view breast tomosynthesis: An analysis of findings leading to recall, work-up and biopsy rates in the Malmo Breast Tomosynthesis Screening Trial.

ABSTRACT: OBJECTIVES:To analyse false positives (FPs) in breast cancer screening with tomosynthesis (BT) vs. mammography (DM). METHODS:The Malmö Breast Tomosynthesis Screening Trial (MBTST) is a prospective population-based study comparing one-view BT to DM in screening. This study is based on the first half of the MBTST population (n?=?7,500). Differences in FP recall rate, findings leading to recall, work-up and biopsy rate between cases recalled on BT alone, DM alone and BT+DM were analysed. RESULTS:The FP recall rate was 1.7 % for BT alone (n?=?131), 0.9 % for DM alone (n?=?69) and 1.1 % for BT?+?DM (n?=?81). The FP recall rate for BT alone was halved after the initial phase of the trial, stabilising at 1.5 %. BT doubled the recall of stellate distortions compared to DM (n?=?64 vs. n?=?33). There were fewer fibroadenomas and cysts, and the biopsy rate was slightly lower for FP recalled on BT alone compared to DM alone (15.3 % vs. 27.6 %: p?=?0.037 and 33.8 % vs. 36.2 %; p?=?0.641, respectively). CONCLUSIONS:FPs increased with BT screening mainly due to the recall of stellate distortions. The FP recall rate was still well within the European guidelines and showed evidence of a learning curve. Characterisation of rounded lesions was improved with BT. KEY POINTS:• Tomosynthesis screening gave a higher false-positive recall rate than mammography • There was a decline in the false-positive recall rate for tomosynthesis • The recall due to stellate distortions simulating malignancy was doubled with tomosynthesis • Tomosynthesis found more radial and postoperative scar tissue than mammography • Tomosynthesis is better at characterising rounded lesions.

SUBMITTER: Lang K 

PROVIDER: S-EPMC5052302 | biostudies-literature | 2016 Nov

REPOSITORIES: biostudies-literature