Category: News

Directors of mammography screening programs are interested in raising awareness among women regarding the benefits of low-dose CT (LDCT) screening for lung cancer, but they need more training, according to a study published February 26 in the Journal of the American College of Radiology. “Additional tools, training, and/or staffing may be necessary to leverage the full potential of reaching women at high risk for lung cancer within the context of mammographic screening,” wrote a team led by Jan Eberth, PhD, of the University of South Carolina in Columbia.

Even though there’s evidence that low-dose CT screening for lung cancer among those at high risk of the disease is beneficial, awareness and uptake of it remain low, Eberth and colleagues noted. The group sought to investigate American College of Radiology (ACR) mammography screening program directors’ views about how to raise LDCT screening awareness by identifying women at high risk of lung cancer who participate in routine mammography.

The study consisted of an online survey and telephone interviews with 18 program directors. Key themes included the following:

• Attitudes toward the integration of LDCT screening into a mammography program
• Identifying mammography patients at high risk for lung cancer
• Counseling about LDCT screening
• Increasing awareness and knowledge of LDCT screening

Eberth and colleagues found that, overall, mammography screening program directors were interested in leveraging their programs to educate women about lung cancer screening.

“Overall, mammography program directors recognized the benefits of integrating mammography and LDCT screening and were receptive to educating and referring women for LDCT screening,” the group concluded. “However, training and workflow changes are needed to ensure successful implementation.”

Source: AuntMinnie.com staff writer

Digital breast tomosynthesis (DBT) found more than twice as many cancers as full-field digital mammography alone (FFDM) or a combination of the two technologies in a recent study, published online February 14 in the Journal of the American College of Radiology. The findings offer further evidence that DBT is a viable screening modality, wrote a team led by Dr. Laila Cochon of Brigham and Women’s Hospital in Boston.

“We found that compared with FFDM, DBT improves breast cancer detection in screening mammography, which more than doubled (2.6 versus 6 cancers per 1,000),” the group wrote. “Although overall recall rate did not change with DBT when compared with FFDM, even over time, an improvement in PPV1 [positive predictive value for number of cancers per number of recalls] reflects a reduction in unnecessary recalls.”

Digital mammography can miss up to 30% of breast cancers — a statistic that has prompted the search for better breast cancer screening technology, the team noted. Previous studies comparing FFDM to DBT have shown that DBT increases cancer detection rates and reduces recalls, but these studies haven’t necessarily examined the use of DBT alone.

“Large studies comparing the efficacy of FFDM versus DBT demonstrate that DBT increases cancer detection rates … and reduces recalls, but many of these studies were observational and occurred in mixed FFDM and DBT imaging environments, with the potential for selection bias among patients undergoing each technology,” the authors noted.

Therefore, the researchers decided to compare differences in breast screening metrics in a large practice during three periods: an FFDM-only environment (pre-DBT), a hybrid DBT and FFDM environment, and a DBT-only environment.

The study included 179,028 screening mammograms acquired between January 2011 and December 2017. The group used electronic record data to glean patient demographic information and BI-RADS scores from each exam report; primary performance outcome measures were recall rate, cancer detection rate, and positive predictive value for screening recall (PPV1).

Of the 179,028 screening mammograms, 41,818 (23.3%) were FFDM only, 83,125 (46.4%) were FFDM/DBT, and 54,084 (30.2%) were DBT only. Cochon’s group found that, with the exception of the recall rate, DBT demonstrated statistically significant screening performance improvements.

The fact that the recall rate remained stable across the three clinical environments but that the cancer detection rate and the PPV1 increased demonstrates DBT’s efficacy as a breast cancer screening tool, according to Cochon and colleagues.”Even without significant reduction in recall rate, the improvements in CDR and PPV1 demonstrate that DBT is a technological advance in breast cancer screening,” the group concluded.

By Kate Madden Yee,
AuntMinnie.com staff writer