Impact of digital breast tomosynthesis on screening performance and interval cancer rates compared to digital mammography: A meta-analysis

Abstract

Background The performance of digital breast tomosynthesis (DBT) alone, digital mammography (DM) plus DBT, and synthesized mammography (SM) plus DBT, in comparison to DM in breast cancer screening, remains a topic of ongoing debate. The effectiveness of these modalities in reducing interval cancer rates (ICR) is particularly contentious. Materials and methods A database of data was searched for articles published until July 2024. Initially, the pooled sensitivity and specificity of DBT (DBT alone, DM/DBT, and SM/DBT) and DM were estimated. Additionally, the sensitivity of breast cancer screening and ICR for DBT alone, DM/DBT, and SM/DBT compared to DM. The characteristics of interval breast cancer were compared with those screening BC, alongside differences across various screening methods. Results Eleven studies comparing DBT and DM were included. The sensitivity of DBT was higher than that of DM, with rates of 86% (95%CI: 81, 90) and 80% (95%CI: 76, 84), respectively. The specificities of both modalities were similar, recorded at 96% (95%CI: 95, 98) and 96% (95%CI: 95, 97), respectively. In comparison to DM, the screening sensitivities of DBT, DM/DBT, and SM/DBT were increased by 4.33% (95% CI: 1.52, 7.13), 6.29% (95% CI: 2.55, 10.03), and 5.22% (95% CI: 1.35, 9.10), respectively; however, the difference in the ICR was not statistically significant. Conclusion DBT offers advantages in enhancing the sensitivity of breast cancer screening; however, its impact on ICR remains uncertain. Consequently, further research is necessary to comprehensively evaluate both the effectiveness of screening and the potential risks associated with DBT.