Radiology: How much breast cancer will be missed without digital mammography?

Background Compared with pure digital mammography (DM) screening, digital mammography (DBT) can improve the detection and retest rate of breast cancer;
(FN) in screening can be used as an alternative indicator of long-term prognosis, such as breast cancer morbidity and mortality.
purpose of this study is to verify that breast cancer screening using DBT is associated with lower FN, better prognosis detection of breast cancer, and better diagnostic results than DM.
retrospective study of materials and methodo schools incorporated data from 10 institutions and communities.
DBT is conducted 1 year after DM screening, starting june 30, 2013 to 2016 data collection, 2018-2019 analysis.
analysis of the clinical manifestations of cancer, asymptomatic or asymptomatic.
FN rate, sensitivity, specificity, tumor detection rate, retest rate, positive prediction value, tumor size, histological characteristics and subject signs.
380,641 screening tests were included in the study.
183989 and 196652 cases were examined by DBT and DM respectively.
in DBT, the overall FN inspection rate is low (DBT, 0.6 per 1000 screens; DM, 0.7 per 1000 screens; P - .20), patients with FN check-ups and symptoms (DBT, 0.4 per 1000 screens; DM, 0.5 per 1000 screens; The ratio of P to .21) is low.
high rates of FN screening and asymptomatic, breast-tight patients (DBT, 0.14 per 1000 screens; DM: 0.07 per 1000 screens; P = .07).。
sensitivity in the case of DBT (DBT, 89.8% (966 of 1076 cancers); DM, 85.6% [789 of 922 cancers]; P - .004), specificity (DBT, 90.7% (165 830 of 182 913 examinations); DM, 89.1% [174 480 of 195 730 examinations]; both of the P-lt; .001) are elevated.
as a whole, breast cancers examined with DBT were mostly immersive (P .lt; .001), had fewer positive lymph nodes (P .04) and distant metastasis (P s .01), and had a lower rate of FN incidence of advanced breast cancer (odds ratio, 0.95% CI: 0.5, 1.5).
conclusion that breast cancer screening using digital mammography can improve the sensitivity and specificity of diagnosis of less positive lymph nodes or distant metastatic breast cancer, especially in leaching breast cancer.
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