Tomosynthesis detects breast cancer more frequently during screening
With around 75,000 new cases per year, breast cancer is by far the most common cancer among women in Germany. Using digital breast tomosynthesis in the breast cancer screening program could prevent around a quarter of invasive interval cancers that occur within two years after a digital mammogram.
Breast cancer is the most prevalent cancer among women in Germany, with approximately 75,000 new cases reported annually. Digital breast tomosynthesis, a diagnostic technique utilizing low-dose X-rays taken from different angles, has shown promise in early detection. Research conducted by a team from the University of Münster and University Hospital Münster, in collaboration with other partners, aimed to compare the effectiveness of tomosynthesis and conventional digital mammography in screening programs.
The study, known as TOSYMA, is the largest comparative trial of its kind conducted globally. It found that tomosynthesis detected 7.1 invasive breast cancers per 1,000 women screened, compared to 4.8 per 1,000 women for digital mammography. Moreover, in the first year after a normal screening result, invasive breast cancer diagnoses were 29% lower in the tomosynthesis group than in the mammography group.
This suggests that tomosynthesis may prevent a significant portion of invasive interval cancers that occur within two years of digital mammography.
The researchers also noted that the diagnostic effect was more pronounced among women who participated in a second screening round. In this group, the invasive cancer rate after two years was 13.5 per 10,000 women, which was 24% lower than the 18.6 per 10,000 women in the mammography group. Additionally, interval cancers in the tomosynthesis group were less likely to be locally advanced or have spread to the axillary lymph nodes, both of which are considered positive indicators of effective early detection.
The study, published in The Lancet Oncology, was carried out among nearly 100,000 women aged 50-70 from 17 screening centers in North Rhine-Westphalia and Lower Saxony. Participants were randomly assigned to either tomosynthesis or digital mammography, both of which were conducted under real-world conditions within the existing mammography screening program.
The study aimed to determine whether tomosynthesis reduced advanced tumor stages more effectively than mammography in screening. Further analysis of the carcinomas detected during regular follow-up screening for women in both groups is currently underway.
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