Digital breast tomosynthesis (DBT): recommendations from the Italian College of Breast Radiologists (ICBR) by the Italian Society of Medical Radiology ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-05-25

AUTHORS

Daniela Bernardi, Paolo Belli, Eva Benelli, Beniamino Brancato, Lauro Bucchi, Massimo Calabrese, Luca A. Carbonaro, Francesca Caumo, Beatrice Cavallo-Marincola, Paola Clauser, Chiara Fedato, Alfonso Frigerio, Vania Galli, Livia Giordano, Paolo Giorgi Rossi, Paola Golinelli, Doralba Morrone, Giovanna Mariscotti, Laura Martincich, Stefania Montemezzi, Carlo Naldoni, Adriana Paduos, Pietro Panizza, Federica Pediconi, Fiammetta Querci, Antonio Rizzo, Gianni Saguatti, Alberto Tagliafico, Rubina M. Trimboli, Marco Zappa, Chiara Zuiani, Francesco Sardanelli

ABSTRACT

This position paper, issued by ICBR/SIRM and GISMa, summarizes the evidence on DBT and provides recommendations for its use. In the screening setting, DBT in adjunct to digital mammography (DM) increased detection rate by 0.5–2.7‰ and decreased false positives by 0.8–3.6% compared to DM alone in observational and double-testing experimental studies. The reduction in recall rate could be less prominent in those screening programs which already have low recall rates with DM. The increase in radiation exposure associated with DM/DBT protocols has been solved by the introduction of synthetic mammograms (sDM) reconstructed from DBT datasets. Thus, whenever possible, sDM/DBT should be preferred to DM/DBT. However, before introducing DBT as a routine screening tool for average-risk women, we should wait for the results of randomized controlled trials and for a statistically significant and clinically relevant reduction in the interval cancer rate, hopefully associated with a reduction in the advanced cancer rate. Otherwise, a potential for overdiagnosis and overtreatment cannot be excluded. Studies exploring this issue are ongoing. Screening of women at intermediate risk should follow the same recommendations, with particular protocols for women with previous BC history. In high-risk women, if mammography is performed as an adjunct to MRI or in the case of MRI contraindications, sDM/DBT protocols are suggested. Evidence exists in favor of DBT usage in women with clinical symptoms/signs and asymptomatic women with screen-detected findings recalled for work-up. The possibility to perform needle biopsy or localization under DBT guidance should be offered when DBT-only findings need characterization or surgery. More... »

PAGES

723-730

References to SciGraph publications

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  • Journal

    TITLE

    La radiologia medica

    ISSUE

    10

    VOLUME

    122

    Author Affiliations

  • U.O. Senologia Clinica e Screening Mammografico, Dipartimento di Radiologia, APSS, Centro per i Servizi Sanitari, Pal. C, viale Verona, 38123, Trento, Italy
  • Dipartimento di Scienze Radiologiche, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy
  • Zadig Scientific Communication Agency, Via Arezzo 21, 00161, Rome, Italy
  • Struttura Complessa di Senologia Clinica, Istituto per lo Studio e la Prevenzione Oncologica (ISPO), Via Cosimo il Vecchio 2, 50139, Florence, Italy
  • Romagna Cancer Registry, Romagna Cancer Institute (IRST) IRCCS, Via Piero Maroncelli 40, Meldola, 47014, Forlì, Italy
  • UOC Senologia Diagnostica, IRCCS AOU San Martino-IST, Largo Rosanna Benzi 10, 16132, Genoa, Italy
  • Unit of Radiology, IRCCS Policlinico San Donato, Via Morandi 30, San Donato Milanese, 20097, Milan, Italy
  • UOSD Breast Unit ULSS 20, Piazza Lambranzi 1, 37142, Verona, Italy
  • Dipartimento di Scienze Radiologiche, Oncologiche ed Anatomo-patologiche, Policlinico Umberto I, Sapienza Università di Roma, Viale Regina Elena 324, 00161, Rome, Italy
  • Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna/General Hospital Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
  • Regional Screening Coordinating Centre, Veneto Region, Venice, Italy
  • Regional Reference Centre for Breast Cancer Screening, Turin, Italy
  • Mammography Screening Centre, Local Health Authority, Modena, Italy
  • Epidemiology Unit, Centre for Cancer Prevention, Turin, Italy
  • Interinstitutional Epidemiology Unit, AUSL Reggio Emilia, and Arcispedale S. Maria Nuova, Reggio Emilia, Italy
  • Medical Physics Service, Local Health Authority, Modena, Italy
  • Radiologia 1U, Dipartimento di Diagnostica per Immagini, Università di Torino, A. O. U. Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Turin, Italy
  • U.O. Radiodiagnostica, Candiolo Cancer Institute, FPO, IRCCS, Strada Provinciale 142, km 3.95, Candiolo, 10060, Turin, Italy
  • DAI Patologia e Diagnostica, Azienda Ospedaliera Universitaria Integrata, Piazzale A. Stefani 1, 37126, Verona, Italy
  • Department of Health, Emilia-Romagna Region, Bologna, Italy
  • U.O. Radiologia Senologica, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy
  • Department of Prevention, Screening Centre, Local Health Authority, Sassari, Italy
  • Pathology Department, Local Health Authority, Asolo, Treviso, Italy
  • Senology Unit, Local Health Authority, Bologna, Italy
  • Department of Experimental Medicine, DIMES, Institute of Anatomy, University of Genova, Via de Toni 14, 16132, Genoa, Italy
  • Department of Biomedical Science for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy
  • UOC Epidemiologia Clinica, Istituto per lo Studio e la Prevenzione Oncologica (ISPO), Florence, Italy
  • Institute of Radiology, University of Udine, Piazzale S. M. della Misericordia 15, 33100, Udine, Italy
  • Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Morandi 30, San Donato Milanese, 20097, Milan, Italy
  • Clinical Trials linked to this publication

    Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s11547-017-0769-z

    DOI

    http://dx.doi.org/10.1007/s11547-017-0769-z

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1085588919

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/28540564


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