A Randomized Trial Comparing Breast Cancer Incidence and Interval Cancers after Tomosynthesis Plus Mammography versus Mammography Alone.

Breast Neoplasms / diagnostic imaging Female Humans Incidence Male Mammography / methods Prospective Studies Sensitivity and Specificity

Journal

Radiology
ISSN: 1527-1315
Titre abrégé: Radiology
Pays: United States
ID NLM: 0401260

Informations de publication

Date de publication:
05 2022
Historique:
pubmed: 2 2 2022
medline: 28 4 2022
entrez: 1 2 2022
Statut: ppublish

Résumé

Background Adding digital breast tomosynthesis (DBT) to digital mammography (DM) improves breast cancer screening sensitivity, but how this impacts mortality and other end points is unknown. Purpose To compare interval and overall breast cancer incidence after screening with DBT plus DM versus DM alone. Materials and Methods In this prospective trial (RETomo), women attending screening were randomized to one round of DBT plus DM (experimental arm) or to DM (control arm). All were then rescreened with DM after 12 months (women aged 45-49 years) or after 24 months (50-69 years). The primary outcome was interval cancer incidence. Cumulative incidence up to the subsequent screening round plus 9 months (21- and 33-month follow-up for women aged 45-49 and 50-69, respectively) was also reported. Ductal carcinomas in situ are included. Subgroup analyses by age and breast density were conducted; 95% CIs computed according to binomial distribution are reported. Results Baseline cancer detection was higher in the DBT plu DM arm than DM arm (101 of 13 356 women vs 61 of 13 521 women; relative detection, 1.7 [95% CI: 1.2, 2.3]). The mean age ± standard deviation for the women in both arms was 55 years ± 7. Interval cancer incidence was similar in the two arms (21 vs 22 cancers; relative incidence, 0.97 [95% CI: 0.53, 1.8]). Cumulative incidence remained higher in the DBT plus DM arm in women over 50 (153 vs 124 cancers; relative incidence, 1.2 [95% CI: 0.99, 1.6]), while it was similar in the two arms in women aged 45-49 (36 vs 41 cancers; relative incidence, 0.89 [95% CI: 0.57, 1.4]). Conclusion In women younger than 50 years, the benefit of early diagnosis seemed to be appreciable, while for women over age 50, the higher sensitivity of tomosynthesis plus mammography was not matched by a subsequent reduction in cancers at the next screening examination or in the intervening interval. Clinical trial registration no. NCT02698202 © RSNA, 2022

Identifiants

DOI: 10.1148/radiol.211132 PMID: 35103537
pubmed: 35103537
doi: 10.1148/radiol.211132
doi:

Banques de données

ClinicalTrials.gov
['NCT02698202']

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

256-266

Investigateurs

Carlo Alberto Mori (CA)
Chiara Coriani (C)
Manuela Pescarolo (M)
Gloria Stefanelli (G)
Giulio Tondelli (G)
Filippo Beretti (F)
Sabrina Caffarri (S)
Vanessa Marchesi (V)
Luisa Paterlini (L)
Stefania Caroli (S)
Laura Canovi (L)
Marco Colli (M)
Mirco Boschini (M)
Marco Bertolini (M)
Kristina Lang (K)
Axel Graewingholt (A)
Fabio Falcini (F)

Commentaires et corrections

Type : CommentIn

Auteurs

Pierpaolo Pattacini (P)

From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.).
ORCID: 0000-0003-2530-5698

Andrea Nitrosi (A)

From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.).
ORCID: 0000-0003-4271-3677

Paolo Giorgi Rossi (P)

From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.).
ORCID: 0000-0001-9703-2460

Stephen W Duffy (SW)

From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.).
ORCID: 0000-0003-4901-7922

Valentina Iotti (V)

From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.).

Vladimiro Ginocchi (V)

From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.).
ORCID: 0000-0003-3218-4695

Sara Ravaioli (S)

From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.).

Rita Vacondio (R)

From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.).

Pamela Mancuso (P)

From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.).

Moira Ragazzi (M)

From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.).

Cinzia Campari (C)

From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.).
ORCID: 0000-0002-2535-568X
From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.).

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Classifications MeSH

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questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Imagerie diagnostique › Radiographie › Mammographie › A Randomized Trial Comparing Breast Cancer...
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