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Jakob Olinder

Doctoral student

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False-positive recalls in the prospective Malmö Breast Tomosynthesis Screening Trial

Author

  • Kristin Johnson
  • Jakob Olinder
  • Aldana Rosso
  • Ingvar Andersson
  • Kristina Lång
  • Sophia Zackrisson

Summary, in English

Objectives: To evaluate the total number of false-positive recalls, including radiographic appearances and false-positive biopsies, in the Malmö Breast Tomosynthesis Screening Trial (MBTST). Methods: The prospective, population-based MBTST, with 14,848 participating women, was designed to compare one-view digital breast tomosynthesis (DBT) to two-view digital mammography (DM) in breast cancer screening. False-positive recall rates, radiographic appearances, and biopsy rates were analyzed. Comparisons were made between DBT, DM, and DBT + DM, both in total and in trial year 1 compared to trial years 2 to 5, with numbers, percentages, and 95% confidence intervals (CI). Results: The false-positive recall rate was higher with DBT, 1.6% (95% CI 1.4; 1.8), compared to screening with DM, 0.8% (95% CI 0.7; 1.0). The proportion of the radiographic appearance of stellate distortion was 37.3% (91/244) with DBT, compared to 24.0% (29/121) with DM. The false-positive recall rate with DBT during trial year 1 was 2.6% (95% CI 1.8; 3.5), then stabilized at 1.5% (95% CI 1.3; 1.8) during trial years 2 to 5. The percentage of stellate distortion with DBT was 50% (19/38) trial year 1 compared to 35.0% (72/206) trial years 2 to 5. Conclusions: The higher false-positive recall rate with DBT compared to DM was mainly due to an increased detection of stellate findings. The proportion of these findings, as well as the DBT false-positive recall rate, was reduced after the first trial year. Clinical relevance statement: Assessment of false-positive recalls gives information on potential benefits and side effects in DBT screening. Key Points: • The false-positive recall rate in a prospective digital breast tomosynthesis screening trial was higher compared to digital mammography, but still low compared to other trials. • The higher false-positive recall rate with digital breast tomosynthesis was mainly due to an increased detection of stellate findings; the proportion of these findings was reduced after the first trial year.

Department/s

  • LUCC: Lund University Cancer Centre
  • Radiology Diagnostics, Malmö
  • Geriatrics
  • EpiHealth: Epidemiology for Health
  • eSSENCE: The e-Science Collaboration
  • LU Profile Area: Light and Materials
  • LTH Profile Area: Photon Science and Technology

Publishing year

2023

Language

English

Pages

8089-8099

Publication/Series

European Radiology

Volume

33

Issue

11

Document type

Journal article

Publisher

Springer

Topic

  • Cancer and Oncology

Keywords

  • Breast neoplasm
  • Female
  • Mammography
  • Mass screening

Status

Published

Research group

  • Radiology Diagnostics, Malmö
  • Geriatrics

ISBN/ISSN/Other

  • ISSN: 0938-7994