Screening Performance of Digital Breast Tomosynthesis vs Digital Mammography in Community Practice by Patient Age, Screening Round, and Breast Density

Key Points Question Does screening performance of digital breast tomosynthesis vs digital mammography differ by breast density, age, or screening round in community practice? Findings In this comparative effectiveness study assessing 1 584 079 screening examinations across 46 US facilities, the largest improvements in recall and cancer detection rates with digital breast tomosynthesis were observed on baseline screens. On subsequent screens, both recall and cancer detection rates improved using digital breast tomosynthesis vs digital mammography for women aged 40 to 79 years with heterogeneously dense breasts and for women aged 50 to 79 years with scattered fibroglandular density; by contrast, performance was similar in women with extremely dense breasts. Meaning Women undergoing baseline screening may benefit most from digital breast tomosynthesis, whereas on subsequent screens, the benefits of digital breast tomosynthesis may vary by age and density category.