Table 4.
Screening outcomes for digital breast tomosynthesis in combination with digital mammography (DBT) compared to digital mammography (DM) alone by age and breast density
| DM | DBT | p-value | Unadjusted | Adjusted§ | |||||
|---|---|---|---|---|---|---|---|---|---|
| n | % | n | % | OR | 95% CI | OR | 95% CI | ||
| Recall rate* | |||||||||
| Age 40–49 | 5479 | 14.8 | 2124 | 11.4 | <0.0001 | 0.74 | (0.70–0.90) | 0.65 | (0.61–0.70) |
| Age 50–74 | 9405 | 8.9 | 2732 | 7.3 | <0.0001 | 0.81 | (0.77–0.85) | 0.71 | (0.67–0.74) |
| Nondense† | 7861 | 9.1 | 2328 | 7.4 | <0.0001 | 0.80 | (0.76–0.83) | 0.67 | (0.63–0.71) |
| Dense† | 5561 | 12.6 | 2186 | 10.3 | <0.0001 | 0.80 | (0.76–0.85) | 0.70 | (0.66–0.74) |
| Biopsy rate* | |||||||||
| Age 40–49 | 851 | 2.3 | 424 | 2.3 | 0.904 | 0.99 | (0.88–1.12) | 0.86 | (0.75–1.00) |
| Age 50–74 | 1696 | 1.6 | 675 | 1.8 | 0.0088 | 1.13 | (1.03–1.24) | 0.83 | (0.74–0.94) |
| Nondense† | 1221 | 1.4 | 598 | 1.9 | <0.0001 | 1.35 | (1.22–1.49) | 0.92 | (0.81–1.04) |
| Dense† | 979 | 2.2 | 458 | 2.2 | 0.754 | 0.98 | (0.88–1.10) | 0.79 | (0.69–0.90) |
| Cancer rate per 1,000‡ | |||||||||
| Age 40–49 | 104 | 3.4 | 47 | 5.6 | 0.0053 | 1.66 | (1.17–2.34) | 1.63 | (1.04–2.56)|| |
| Age 50–74 | 447 | 5.4 | 117 | 7.0 | 0.0210 | 1.28 | (1.04–1.57) | 1.35 | (1.02–1.79) |
| Nondense† | 299 | 4.5 | 87 | 5.6 | 0.0787 | 1.25 | (0.98–1.58) | 1.58 | (1.14–2.19) |
| Dense† | 193 | 5.5 | 73 | 7.8 | 0.0100 | 1.44 | (1.10–1.88) | 1.39 | (0.97–1.99) |
| Cancer detection rate per 1,000‡ | |||||||||
| Age 40–49 | 89 | 2.9 | 40 | 4.7 | 0.0130 | 1.65 | (1.13–2.39) | 1.53 | (0.93–2.50)|| |
| Age 50–74 | 410 | 5.0 | 109 | 6.5 | 0.0163 | 1.30 | (1.05–1.61) | 1.33 | (0.99–1.79) |
| Nondense† | 275 | 4.1 | 82 | 5.3 | 0.0580 | 1.28 | (1.00–1.63) | 1.55 | (1.11–2.18) |
| Dense† | 166 | 4.7 | 63 | 6.8 | 0.0117 | 1.44 | (1.08–1.93) | 1.31 | (0.88–1.95) |
| PPV1 (cancers/recall)‡, % | |||||||||
| Age 40–49 | 89 | 1.9 | 40 | 3.8 | 0.0005 | 2.02 | (1.38–2.95) | 1.96 | (1.18–3.26)|| |
| Age 50–74 | 410 | 5.5 | 109 | 8.6 | <0.0001 | 1.63 | (1.31–2.03) | 1.79 | (1.31–2.45) |
| Nondense† | 275 | 4.4 | 82 | 6.6 | 0.0013 | 1.54 | (1.19–1.98) | 2.32 | (1.62–3.34) |
| Dense† | 166 | 3.7 | 63 | 6.0 | 0.0010 | 1.69 | (1.25–2.27) | 1.70 | (1.13–2.56) |
Recall rate includes BIRADS 0, 3, 4, and 5 exams. Total number of exams for recall rate and biopsy rate: n=142,883 DM, n=55,998 DBT.
Nondense includes almost entirely fatty (1) and scattered fibroglandular densities (2). Dense includes heterogeneously dense (3) and extremely dense (4).
Cancer rates, cancer detection rates, and PPV1s were restricted to women under observation for at least 1 year. Total number of exams: n=113,061 DM, n=25,268 DBT.
Adjusted for center and first exam. ORs by age are additionally adjusted for breast density (categories 1, 2, 3, 4) when possible. ORs by breast density are additionally adjusted for age (age 40–49, 50–59, 60–74).
Adjusted only for center and first exam.