[Digital tomosynthesis for breast cancer]
Donato M, Bardach A, Pichon-Riviere A, Augustovski F, García Martí S, Alcaraz A, Ciapponi A.
Record ID 32018001573
Original Title: Tomosíntesis digital para cáncer de mama
Authors' recomendations: No studies assessing the effect of digital breast tomosynthesis (3D mammography) on clinical outcomes such as overall survival or progression-free survival in adult females with breast cancer have been found. Low-quality evidence suggests that digital breast tomosynthesis, whether combined with 2D mammography or not, would improve the detection rate and the positive predictive value when compared with 2D mammography in breast cancer screening in asymptomatic 50-to-70-year-old females. It would also improve the detection rate, sensitivity and area under the curve for breast cancer screening in high-risk adult females. Low-quality evidence suggests that digital breast tomosynthesis, whether combined with 2D mammography or not, would improve the detection rate and the area under the curve for breast cancer diagnosis in adult females with suspicious clinical findings of breast cancer. However, it is not clear if this method improves the specificity or decreases the rate of recall for breast cancer screening or diagnosis in these populations. For adult females with high breast density, low-quality evidence suggests that digital breast tomosynthesis, whether combined with 2D mammography or not, would improve the detection rate and sensitivity in breast cancer screening and diagnosis when compared with 2D mammography. However, it is not clear if this method improves specificity or decreases the rate of recall for breast cancer screening or diagnosis in this population. Three clinical practice guidelines from high-income countries do not recommend digital breast tomosynthesis for breast cancer screening in adult females since there is no certainty about its benefits, risks or cost-effectiveness in replacing 2D mammography. One practice guideline recommends it for breast cancer diagnosis in special cases only; however it does not mention which ones. In Latin America, only Colombia covers the technology. Australia and the United States include it for breast cancer screening and diagnosis in adult females; while other two high-income countries expressly do not cover it for these indications in view of the uncertainty of its benefits, risks or cost-effectiveness. No economic evaluations have been found for Argentina or the region. The estimated cost of the procedure when comparing digital breast tomosynthesis with bilateral mammography with axillary projection would be similar in Argentina; however both of them would be more expensive than the cost of breast ultrasound.
Project Status: Completed
Year Published: 2020
URL for published report: https://www.iecs.org.ar/home-ets/
English language abstract: An English language summary is available
Publication Type: Not Assigned
- Breast Neoplasms
- Tomography, X-Ray Computed
- Imaging, Three-Dimensional
- Mass Screening
- Diagnostic Imaging
- Radiographic Image Enhancement
Organisation Name: Institute for Clinical Effectiveness and Health Policy
Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA
Contact Name: firstname.lastname@example.org
Contact Email: email@example.com
Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)
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