TY - JOUR
T1 - Digital breast tomosynthesis (DBT): recommendations from the Italian College of Breast Radiologists (ICBR) by the Italian Society of Medical Radiology (SIRM) and the Italian Group for Mammography Screening (GISMa)
AU - Bernardi, D
AU - Belli, Paolo
AU - Benelli, E
AU - Brancato, B
AU - Bucchi, L
AU - Calabrese, M
AU - Carbonaro, LA
AU - Caumo, F
AU - Cavallo-Marincola, B
AU - Clauser, P
AU - Fedato, C
AU - Frigerio, A
AU - Galli, V
AU - Giordano, L
AU - Rossi, PG
AU - Golinelli, P
AU - Morrone, D
AU - Mariscotti, G
AU - Martincich, L
AU - Montemezzi, S
AU - Naldoni, C
AU - Paduos, A
AU - Panizza, P
AU - Pediconi, F
AU - Querci, F
AU - Rizzo, A
AU - Saguatti, G
AU - Tagliafico, A
AU - Trimboli, RM
AU - Zappa, M
AU - Zuiani, C
AU - Sardanelli, F
PY - 2017
Y1 - 2017
N2 - This position paper, issued by ICBR/SIRM and GISMa, summarizes the evidence on DBT and provides recommendations for its use. In the screening setting, DBT in adjunct to digital mammography (DM) increased detection rate by 0.5-2.7aEuro degrees and decreased false positives by 0.8-3.6% compared to DM alone in observational and double-testing experimental studies. The reduction in recall rate could be less prominent in those screening programs which already have low recall rates with DM. The increase in radiation exposure associated with DM/DBT protocols has been solved by the introduction of synthetic mammograms (sDM) reconstructed from DBT datasets. Thus, whenever possible, sDM/DBT should be preferred to DM/DBT. However, before introducing DBT as a routine screening tool for average-risk women, we should wait for the results of randomized controlled trials and for a statistically significant and clinically relevant reduction in the interval cancer rate, hopefully associated with a reduction in the advanced cancer rate. Otherwise, a potential for overdiagnosis and overtreatment cannot be excluded. Studies exploring this issue are ongoing. Screening of women at intermediate risk should follow the same recommendations, with particular protocols for women with previous BC history. In high-risk women, if mammography is performed as an adjunct to MRI or in the case of MRI contraindications, sDM/DBT protocols are suggested. Evidence exists in favor of DBT usage in women with clinical symptoms/signs and asymptomatic women with screen-detected findings recalled for work-up. The possibility to perform needle biopsy or localization under DBT guidance should be offered when DBT-only findings need characterization or surgery.
AB - This position paper, issued by ICBR/SIRM and GISMa, summarizes the evidence on DBT and provides recommendations for its use. In the screening setting, DBT in adjunct to digital mammography (DM) increased detection rate by 0.5-2.7aEuro degrees and decreased false positives by 0.8-3.6% compared to DM alone in observational and double-testing experimental studies. The reduction in recall rate could be less prominent in those screening programs which already have low recall rates with DM. The increase in radiation exposure associated with DM/DBT protocols has been solved by the introduction of synthetic mammograms (sDM) reconstructed from DBT datasets. Thus, whenever possible, sDM/DBT should be preferred to DM/DBT. However, before introducing DBT as a routine screening tool for average-risk women, we should wait for the results of randomized controlled trials and for a statistically significant and clinically relevant reduction in the interval cancer rate, hopefully associated with a reduction in the advanced cancer rate. Otherwise, a potential for overdiagnosis and overtreatment cannot be excluded. Studies exploring this issue are ongoing. Screening of women at intermediate risk should follow the same recommendations, with particular protocols for women with previous BC history. In high-risk women, if mammography is performed as an adjunct to MRI or in the case of MRI contraindications, sDM/DBT protocols are suggested. Evidence exists in favor of DBT usage in women with clinical symptoms/signs and asymptomatic women with screen-detected findings recalled for work-up. The possibility to perform needle biopsy or localization under DBT guidance should be offered when DBT-only findings need characterization or surgery.
KW - Breast cancer
KW - Digital breast tomosynthesis
KW - Mammography
KW - Screening
KW - Breast cancer
KW - Digital breast tomosynthesis
KW - Mammography
KW - Screening
UR - https://publicatt.unicatt.it/handle/10807/171576
UR - https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=85019617431&origin=inward
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85019617431&origin=inward
U2 - 10.1007/s11547-017-0769-z
DO - 10.1007/s11547-017-0769-z
M3 - Article
SN - 0033-8362
VL - 122
SP - 723
EP - 730
JO - LA RADIOLOGIA MEDICA
JF - LA RADIOLOGIA MEDICA
IS - 10
ER -