Digital mammography and digital breast tomosynthesis for detecting invasive lobular and ductal carcinoma

Details

• Alternative Title:
  Breast Cancer Res Treat
• Personal Author:
  Onega, Tracy ; Abraham, Linn ; Miglioretti, Diana L. ; Lee, Christoph I. ; Henderson, Louise M. ; Kerlikowske, Karla ; Tosteson, Anna N.A. ; Weaver, Donald ; Sprague, Brian L. ; Aiello Bowles, Erin J. ; diFlorio-Alexander, Roberta M.
• Description:
  Purpose:
  
  Invasive lobular carcinoma (ILC) is a distinct histological subtype of breast cancer that can make early detection with mammography challenging. We compared imaging performance of digital breast tomosynthesis (DBT) to digital mammography (DM) for diagnoses of ILC, invasive ductal carcinoma (IDC), and invasive mixed carcinoma (IMC) in a screening population.
  
  Methods:
  
  We included screening exams (DM;N=1,715,249 or DBT;N=414,793) from 2011–2018 among 839,801 women in the Breast Cancer Surveillance Consortium. Examinations were followed for one year to ascertain incident ILC, IDC, or IMC. We measured cancer detection rate (CDR) and interval invasive cancer rate/1000 screening examinations for each histological subtype and stratified by breast density and modality. We calculated relative risk (RR) for DM vs. DBT using log-binomial models to adjust for the propensity of receiving DBT vs. DM.
  
  Results:
  
  Unadjusted CDR per 1000 mammograms of ILC overall was 0.33 (95%CI 0.30–0.36) for DM; 0.45 (95%CI 0.39–0.52) for DBT, and for women with dense breasts- 0.33 (95%CI 0.29–0.37) for DM and 0.54 (95%CI 0.43–0.66) for DBT. Similar results were noted for IDC and IMC. Adjusted models showed a significantly increased RR for cancer detection with DBT compared to DM among women with dense breasts for all three histologies (RR; 95%CI: ILC 1.53; 1.09–2.14, IDC 1.21; 1.02–1.44, IMC 1.76; 1.30–2.38), but no significant increase among women with non-dense breasts.
  
  Conclusion:
  
  DBT was associated with higher CDR for ILC, IDC, and IMC for women with dense breasts. Early detection of ILC with DBT may improve outcomes for this distinct clinical entity.
  
  
• Subjects:
  Breast Density Breast Neoplasms Carcinoma, Ductal, Breast Early Detection Of Cancer Female Humans Mammography Mass Screening Retrospective Studies
• Keywords:
  Breast Cancer Breast Density Mammography Tomosynthesis
• Source:
  Breast Cancer Res Treat. 202(3):505-514
• Pubmed ID:
  37697031
• Pubmed Central ID:
  PMC11216536
• Document Type:
  Journal Article
• Funding:
  HHSN261201000140C/CA/NCI NIH HHSUnited States/ ; HHSN261201000035C/CA/NCI NIH HHSUnited States/ ; U54CA163303/CA/NCI NIH HHSUnited States/ ; N01 CN067009/CN/NCI NIH HHSUnited States/ ; U01 CA086076/CA/NCI NIH HHSUnited States/ ; P01 CA154292/CA/NCI NIH HHSUnited States/ ; U54 CA163303/CA/NCI NIH HHSUnited States/ ; HHSN261201300012I/CA/NCI NIH HHSUnited States/ ; PCS-1504-30370/PCORI/Patient-Centered Outcomes Research InstituteUnited States/ ; HHSN261201000035I/CA/NCI NIH HHSUnited States/ ; U58 DP003862/DP/NCCDPHP CDC HHSUnited States/ ; HHSN261201000029C/CA/NCI NIH HHSUnited States/ ; P01CA154292/CA/NCI NIH HHSUnited States/ ; N01PC35142/CA/NCI NIH HHSUnited States/ ; R01 CA149365/CA/NCI NIH HHSUnited States/ ; R50 CA211115/CA/NCI NIH HHSUnited States/ ; HHSN261201000034C/CA/NCI NIH HHSUnited States/ ; N01 CN005230/CN/NCI NIH HHSUnited States/ ; R01 HS018366/HS/AHRQ HHSUnited States/ ; R50CA211115/CA/NCI NIH HHSUnited States/ ; R01CA149365/CA/NCI NIH HHSUnited States/
• Volume:
  202
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:8a4abdc8a8efdcb753634ed4e0fd4f35bd682742a847ed8cf118c5c2e026ed00938d82875210bdc176850c8490717ac19cfbbb565fa5cbcb64b6151a74aa6191
• Download URL:
  https://stacks.cdc.gov/view/cdc/158482/cdc_158482_DS1.pdf
• File Type:
  [PDF - 152.73 KB ]