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Research Letter |

Breast Cancer Screening Using Tomosynthesis and Digital Mammography in Dense and Nondense Breasts

Elizabeth A. Rafferty, MD1,2; Melissa A. Durand, MD3; Emily F. Conant, MD4; Debra Somers Copit, MD5; Sarah M. Friedewald, MD6,7; Donna M. Plecha, MD8; Dave P. Miller, MS9
[+] Author Affiliations
1Department of Radiology, Massachusetts General Hospital, Boston
2now with L&M Radiology, West Acton, Massachusetts
3Yale University School of Medicine, New Haven, Connecticut
4Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia
5Albert Einstein Healthcare Network, Philadelphia, Pennsylvania
6Caldwell Breast Center, Advocate Lutheran General Hospital, Park Ridge, Illinois
7now with Lynn Sage Comprehensive Breast Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois
8University Hospitals Case Medical Center, Cleveland, Ohio
9Genomic Health, Redwood City, California
JAMA. 2016;315(16):1784-1786. doi:10.1001/jama.2016.1708.
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This study compares cancer detection and recall rates with digital mammography combined with tomosynthesis vs digital mammography alone in women with dense breasts.

Breast density is associated with reduced mammographic sensitivity and specificity. Additionally, increased tumor size and worsened prognosis are associated with increased breast density.1,2 Dense breast tissue may also represent an independent risk factor for breast cancer.3 Currently, 24 states have laws mandating that women be notified of the implications of breast density, thereby encouraging discussions between patients and physicians regarding the need for supplemental screening.4 However, which, if any, additional modalities should be recommended for women with dense breasts is not known.

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Figure.
Combined Change in Recall and Cancer Detection Rates for Digital Mammography vs Digital Mammography Plus Tomosynthesis for Each Breast Density Category

The model-adjusted rate was adjusted for screening method and site. The density effect was adjusted for age to account for the potential confounding effect of age on breast density.

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