The Seattle Times published a front-page article on Oct. 27 about 3D mammography. This piece, which was written by Kaiser Health News and published in USA Today last week, stated that digital breast tomosynthesis (DBT or 3D mammography) was no better than 2D. This is simply not true.
Since you or your fellow team members might receive related questions from patients, we wanted to provide you with talking points about the benefits of 3D mammography.
- The Seattle Times article refers to a study published in 2019, which found more cancers in patients getting 3D mammography, but not enough to reach ‘statistical significance.’ Although this Norwegian study involved 30,000 patients, results from a similar study published in The Journal of the American Medical Association (JAMA) in 2014 (Friedewald) looked at 450,000 patients and found a significant increase in cancer detection (29 percent) among Americans who were studied. If the Norwegian study had been larger, it may have reached the same statistical significance.
- While cancer detection is the reason for screening, it is not the only goal. The Norwegian study confirmed that 3D mammography lowers recall or false-positive rates. In that study, rates dropped 22.5 percent. That is significant for patients and groups that cite false positives as a major risk of screening. The 2014 JAMA study also reported a 15 percent decrease in recall – which saves money, time, radiation and anxiety.
- Fewer false positives lead to a significantly better positive predictive value (PPV) for 3D compared to 2D mammography. That is also in the Norwegian study, but not mentioned in the Kaiser Health News article. Again, this saves money, time, radiation and anxiety for patients and the health care industry.
- Other peer-reviewed articles not mentioned in the Kaiser Health News article have shown the simultaneous increase in cancer detection and decrease in false positives. (Skaane, Rafferty, etc.).
- Lastly, the WSRS does not have any industry related relationships that would bias this recommendation.