Nav: Home

More women in US receive 3D mammography but disparities remain

June 24, 2019

New Haven, Conn. -- Use of 3-D mammography, an advanced form of breast cancer screening, has risen rapidly in recent years, according to Yale researchers in a new study. But adoption of the technology varies widely, reflecting emerging disparities in care, they said.

The study was published in the journal JAMA Internal Medicine.

Three-D mammography is also commonly called digital breast tomosynthesis, or DBT. The technology combines low-dose X-rays with software that creates a 3-D image of the breast. Compared to 2-D mammography, DBT may make it easier for radiologists to detect an abnormality. Yet DBT has not been widely endorsed for routine breast cancer screening. Organizations like the U.S. Preventive Services Task Force and the American Cancer Society, which provide guidance to clinicians about cancer screening, have not made recommendations for or against the routine use of DBT.

To assess the extent of DBT use nationwide, the Yale team examined claims data from private health insurance plans. Their investigation included more than 9 million screening exams performed over three years. They also compared DBT use with privately insured versus Medicare-insured patients.

The researchers found that DBT use rose substantially, from 12.9% to 43.2% of screening exams between 2015 and 2017. The increase was consistent among women who were privately insured and women with Medicare.

"DBT has become very popular overall, although uptake has been uneven. In some areas of the country, it is rarely used while in others, it is the predominant mode of screening," said corresponding author Ilana Richman, M.D., assistant professor in the Section of General Internal Medicine at the Yale School of Medicine.

Richman and her co-authors also observed that adoption of DBT varied greatly by region and demographics. Use of the technology grew more quickly in the Northeast and Northwest but more slowly in the Southeast. DBT was more rapidly adopted in areas with higher incomes, greater education, and larger white populations, they said.

While there is evidence that DBT may boost cancer detection rates and reduce false-positive results, more research is needed to determine the true impact of the technology on breast cancer mortality, said the researchers.

"Although there is a lot of interest in this new technology, we don't know much about how it will affect the long-term health of women," Richman noted. "There are ongoing studies designed to answer these questions, and we hope to have clearer answers in the next few years."

The authors predict that, given these findings, DBT will replace 2-D mammography as the standard of care. "These findings highlight how quickly changes in medical practice -- the rate that doctors adopt these new tests -- can eclipse our ability to evaluate whether they are helping patients to live longer and healthier lives," said senior author and professor of medicine Cary Gross, M.D.
-end-
The other Yale authors are Jessica Hoag, Xiao Xu, Howard Forman, Regina Hooley, and Susan Busch.

The Yale researchers accessed the deidentified data through Yale University's participation in the Blue Cross Blue Shield Alliance for Health Research (BCBS Alliance), which engages leading U.S. healthcare researchers in collaborative efforts to improve the health of Americans. Funding for this work was provided by a National Institutes of Health/National Center for Advancing Translational Sciences grant (KL2 TR001862) and by the American Cancer Society. Richman received grants from NIH/NCATS and fees from the Centers for Medicare and Medicaid. Additional disclosures are reported in JAMA Internal Medicine.

Citation: JAMA Internal Medicine

Yale University

Related Mammography Articles:

Six-month follow-up appropriate for BI-RADS 3 findings on mammography
Women with mammographically detected breast lesions that are probably benign should have follow-up surveillance imaging at six months due to the small but not insignificant risk that the lesions are malignant, according to a new study.
Tomosynthesis outperforms digital mammography in five-year study
A new study has found that the advantages of digital breast tomosynthesis (DBT) over digital mammography (DM), including increased cancer detection and fewer false positive findings, are maintained over multiple years and rounds of screening.
More women in US receive 3D mammography but disparities remain
Use of 3D mammography, an advanced form of breast cancer screening, has risen rapidly in recent years, according to Yale researchers in a new study.
Managing architectural distortion on mammography based on MR enhancement
High negative predictive values (NPV) in mammography architectural distortion (AD) without ultrasonographic (US) correlate or magnetic resonance imaging (MRI) enhancement suggests follow-up rather than biopsy may be safely performed, according to a study to be presented at the ARRS 2019 Annual Meeting, set for May 5-10 in Honolulu, Hawaii.
Older women benefit significantly when screened with 3D mammography
Mammography remains an effective method for breast cancer screening in women ages 65 and older, with the addition of a 3D technique called tomosynthesis improving screening performances even more, according to a new study.
3D mammography significantly reduces breast biopsy rates
The use of digital breast tomosynthesis, also known as 3D mammography, may significantly reduce the number of women who undergo breast biopsy for a non-cancerous lesion following an abnormal mammogram, according to a new study.
Digital mammography increases breast cancer detection
The shift from film to digital mammography increased the detection of breast cancer by 14 percent overall in the United Kingdom without increasing the recall rate, according to a major new study.
New study supports mammography screening at 30 for some women
A new, large-scale study of more than 5 million mammograms found that annual mammography screening beginning at age 30 may benefit women with at least one of three specific risk factors: dense breasts, a personal history of breast cancer or a family history of breast cancer.
Women benefit from mammography screening beyond age 75
Women age 75 years and older should continue to get screening mammograms because of the comparatively high incidence of breast cancer found in this age group, according to a new study.
3D mammography detected 34 percent more breast cancers in screening
After screening 15 000 women over a period of five years, a major clinical study in Sweden has shown that 3D mammography, or breast tomosynthesis, detects over 30 percent more cancers compared to traditional mammography - with a majority of the detected tumors proving to be invasive cancers.
More Mammography News and Mammography Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: The Power Of Spaces
How do spaces shape the human experience? In what ways do our rooms, homes, and buildings give us meaning and purpose? This hour, TED speakers explore the power of the spaces we make and inhabit. Guests include architect Michael Murphy, musician David Byrne, artist Es Devlin, and architect Siamak Hariri.
Now Playing: Science for the People

#576 Science Communication in Creative Places
When you think of science communication, you might think of TED talks or museum talks or video talks, or... people giving lectures. It's a lot of people talking. But there's more to sci comm than that. This week host Bethany Brookshire talks to three people who have looked at science communication in places you might not expect it. We'll speak with Mauna Dasari, a graduate student at Notre Dame, about making mammals into a March Madness match. We'll talk with Sarah Garner, director of the Pathologists Assistant Program at Tulane University School of Medicine, who takes pathology instruction out of...
Now Playing: Radiolab

What If?
There's plenty of speculation about what Donald Trump might do in the wake of the election. Would he dispute the results if he loses? Would he simply refuse to leave office, or even try to use the military to maintain control? Last summer, Rosa Brooks got together a team of experts and political operatives from both sides of the aisle to ask a slightly different question. Rather than arguing about whether he'd do those things, they dug into what exactly would happen if he did. Part war game part choose your own adventure, Rosa's Transition Integrity Project doesn't give us any predictions, and it isn't a referendum on Trump. Instead, it's a deeply illuminating stress test on our laws, our institutions, and on the commitment to democracy written into the constitution. This episode was reported by Bethel Habte, with help from Tracie Hunte, and produced by Bethel Habte. Jeremy Bloom provided original music. Support Radiolab by becoming a member today at Radiolab.org/donate.     You can read The Transition Integrity Project's report here.