Digital breast tomosynthesis – the future screening tool for breast cancer?

Digital breast tomosynthesis (DBT) is a new screening and diagnostic technology for breast cancer. Studies from the U.S. have shown that screening with DBT results in a lower recall rate and a higher detection rate compared with digital mammography (DM). Whether a higher detection rate will lead to less false negative screening exams (less interval cancer) and thus a lower mortality, or if it is of influence for other aspects of screening is not known as of today. The economic aspects of DBT are only reported from opportunistic screening in the U.S. In other words, the number of studies on DBT as performed in organized screening programs in Europe and Norway is limited. More studies on early performance measures, including prognostic and predictive tumor characteristics, radiation doses, and the economic aspects are needed to obtain sufficient evidence to assess whether DBT can be recommended as a screening tool in Norway and Europe.

This trial is aimed at testing synthetic 2D + DBT (tomo) versus DM as screening tools in women aged 50-69, who are invited to participate in the Norwegian Breast Cancer Screening Program at Danmarksplass in Bergen. A four months pilot is aimed at testing feasibility, get experiences with, and learning how to read the DBT, and to test practicalities of the project. The trial will start January 1, 2016 and run as a part of the screening program, for two years. Two years follow-up of the participating women will ensure complete data on breast cancer detected before and in the NeXT screening round, in addition to treatment received among women with breast cancer.

The effect of tomo will be evaluated by comparing the achieved early performance measures and economical aspects with those achieved by DM. The comparison of the performance measures will be performed as a part of a PhD while a researcher will perform analyses related to the economic aspects.

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