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Fox Chase Researchers Examine Benefits of Breast Imaging With Advanced Digital Technique

September 28, 2020

PHILADELPHIA (October 1, 2020)—Researchers at Fox Chase Cancer Center recently published a commentary examining clinical practices for breast cancer detection using traditional mammography versus digital breast tomosynthesis on baseline and subsequent screenings.

Tomosynthesis is a type of mammography which uses an X-ray imaging technique to take multiple pictures of the breast and construct a 3D-like set of images. It can be used to identify early signs of breast cancer in women with or without early symptoms.

“The take-home point of this publication is that we’re now getting more information about specifically which women benefit from digital breast tomosynthesis over traditional mammography or digital 2D mammography,” said study author Catherine Tuite, MD, associate professor of radiology and section chief for breast radiology in the Department of Diagnostic Imaging at Fox Chase.

Standard reconstructed 2D mammogram views that are obtained from a digital breast tomosynthesis.Standard reconstructed 2D mammogram views that are obtained from a digital breast tomosynthesis.

According to researchers, mammography remains the standard for breast cancer detection. However, although women who receive breast cancer screenings through mammography have an improved chance of surviving a breast cancer diagnosis, mammograms have limitations such as false positives and high rates of patients coming back for additional screenings.

Tuite said breast tissue density, which can only be determined by a mammogram, is a major factor in the efficacy of mammography. Breast density is categorized as fatty, scattered fibroglandular, heterogeneous, and extremely dense.

She said the more glandular tissue a patient has, the whiter a mammogram appears. In those cases, it’s easier for breast cancer to be hidden in the dense breast tissue and not be visible to a radiologist.

“The tomosynthesis mammogram has been thought to be better for finding abnormalities in dense breast tissue, but previous publications regarding that topic lump heterogeneous and extremely dense categories together and compare them to digital mammography,” said Tuite.

While it’s been shown that all women benefit from tomosynthesis over digital mammogram at baseline screening, this study indicates that results of tomosynthesis in subsequent screenings differ according to individual breast density categories.

“For women with scattered density and heterogeneously dense breasts—the two middle groups—those women benefit from decreased recalls and increased cancer detection with subsequent mammograms using tomosynthesis over a 2D mammogram,” said Tuite.

She added that this new data also found that those women with breast tissue categorized as fatty can benefit from decreased recalls but not necessarily increased cancer detection with tomosynthesis. Additionally, women with extremely dense breast tissue don’t benefit from either decreased recalls or increased cancer detection in subsequent mammograms using tomosynthesis after baseline imaging.

“We’re not quite there yet, but we’re working toward more personalized screening studies for each woman depending on her risk profile. Breast density is an independent risk factor for breast cancer, so now we’re taking that into consideration along with family history, gene mutations, or a host of other factors,” said Tuite.

The study, “Benefits of Digital Breast Tomosynthesis Beyond Baseline Screening,” was published in JAMA Network Open.

      

The Hospital of Fox Chase Cancer Center and its affiliates (collectively “Fox Chase Cancer Center”), a member of the Temple University Health System, is one of the leading cancer research and treatment centers in the United States. Founded in 1904 in Philadelphia as one of the nation’s first cancer hospitals, Fox Chase was also among the first institutions to be designated a National Cancer Institute Comprehensive Cancer Center in 1974. Fox Chase researchers have won the highest awards in their fields, including two Nobel Prizes. Fox Chase physicians are also routinely recognized in national rankings, and the Center’s nursing program has received the Magnet recognition for excellence five consecutive times. Today, Fox Chase conducts a broad array of nationally competitive basic, translational, and clinical research, with special programs in cancer prevention, detection, survivorship and community outreach. It is the policy of Fox Chase Cancer Center that there shall be no exclusion from, or participation in, and no one denied the benefits of, the delivery of quality medical care on the basis of race, ethnicity, religion, sexual orientation, gender, gender identity/expression, disability, age, ancestry, color, national origin, physical ability, level of education, or source of payment.

 

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