Health Problem: In women, breast cancer is the second most common type of cancer and second most common cause of cancer death. Conventional mammography provides 2-dimensional (2D) views of the breasts with notable tissue overlap, in some cases obscuring lesions that may be cancerous or giving a false impression that lesions are present.

Technology Description: Digital breast tomosynthesis (DBT) is similar to a computed tomography scan that only images the breasts. An x-ray source repeatedly sweeps over the breast at regularly spaced intervals to obtain cross-sectional images or “slices” of adjacent segments of tissue.

Controversy: Compared with conventional mammography, DBT requires more complex equipment, more time for image collection and analysis or reading of the final images, and may increase radiation exposure. These extra demands may not outweigh the advantages obtained from less tissue overlap in the final images, particularly when compared with modifications of digital mammography that involve spot compression and magnified and angled views.

Key Questions:

  • Does digital breast tomosynthesis (DBT) provide a more accurate diagnosis than conventional mammography in women with symptoms or suspicious breast lesions?
  • Does DBT reduce the recall and biopsy rates and the rates of breast cancer morbidity and mortality in asymptomatic women who undergo routine screening with this test?
  • Does information obtained with DBT improve patient management and health outcomes?
  • Are there any safety issues associated with the use of DBT?
  • Have definitive patient selection criteria been established for DBT for screening or diagnosis of breast cancer?

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