by Baoqi Zeng, Kai Yu, Le Gao, Xueyang Zeng, Qingxin Zhou
The Breast: Published, July 21, 2021
Purpose
We conducted a systematic review and meta-analysis to
compare the screening performance of synthesized mammography (SM) plus digital
breast tomosynthesis (DBT) with digital mammography (DM) plus DBT or DM alone.
Methods
Medline, Embase, Web of Science, and the Cochrane Library
databases were searched from January 2010 to January 2021. Eligible
population-based studies on breast cancer screening comparing SM/DBT with
DM/DBT or DM in asymptomatic women were included. A random-effect model was
used in this meta-analysis. Data were summarized as risk differences (RDs),
with 95 % confidence intervals (CIs).
Results
Thirteen studies involving 1,370,670 participants were
included. Compared with DM/DBT, screening using SM/DBT had similar breast
cancer detection rate (CDR) (RD = −0.1/1000 screens, 95 % CI = −0.4 to 0.2,
p = 0.557, I2 = 0 %), but lower recall rate (RD = −0.56 %, 95 % CI = −1.03 to
−0.08, p = 0.022, I2 = 90 %) and lower biopsy rate (RD = −0.33 %, 95 %
CI = −0.56 to −0.10, p = 0.005, I2 = 78 %). Compared with DM, SM/DBT improved
CDR (RD = 2.0/1000 screens, 95 % CI = 1.4 to 2.6, p < 0.001, I2 = 63 %) and
reduced recall rate (RD = −0.95 %, 95 % CI = −1.91 to −0.002, p = 0.049, I2 = 99 %).
However, SM/DBT and DM had similar interval cancer rate (ICR) (RD = 0.1/1000
screens, 95 % CI = −0.6 to 0.8, p = 0.836, I2 = 71 %) and biopsy rate
(RD = −0.05 %, 95 % CI = −0.35 to 0.24, p = 0.727, I2 = 93 %).
Conclusions
Screening using SM/DBT has similar breast cancer detection
but reduces recall and biopsy when compared with DM/DBT. SM/DBT improves CDR
when compared with DM, but they have little difference in ICR. SM/DBT could
replace DM/DBT in breast cancer screening to reduce radiation dose.
