Histological subtype and receptor characteristics of cancers detected or missed by digital mammography and tomosynthesis : Results from MAITA randomized trials
(2026) In European Journal of Cancer 238. p.1-10- Abstract
Background Screening with digital breast tomosynthesis (DBT) detects more cancers than with digital mammography (DM), but has small effect, if any, on interval cancer incidence. Methods Data were pooled from two randomized trials within the MAITA Consortium, including 100743 women (664 cancers) screened at baseline and 82938 women (550 cancers) followed for cumulative incidence at subsequent round. At baseline, women were randomized to DBT+DM or DM alone; subsequent round used DM only. We compare the histological characteristics of cancers detected in women screened with DBT+DM versus DM alone, both at recruitment and after a negative screening result. No statistical tests are applied, except for interval cancers and cumulative... (More)
Background Screening with digital breast tomosynthesis (DBT) detects more cancers than with digital mammography (DM), but has small effect, if any, on interval cancer incidence. Methods Data were pooled from two randomized trials within the MAITA Consortium, including 100743 women (664 cancers) screened at baseline and 82938 women (550 cancers) followed for cumulative incidence at subsequent round. At baseline, women were randomized to DBT+DM or DM alone; subsequent round used DM only. We compare the histological characteristics of cancers detected in women screened with DBT+DM versus DM alone, both at recruitment and after a negative screening result. No statistical tests are applied, except for interval cancers and cumulative incidence. Findings At the first round, the detection rate was 50% higher in the DBT arm compared to the DM arm. The overall incidence of interval cancers was similar in the two arms (IRR 0.95 (0.69-1.32)). At the subsequent round, the detection was 14% lower in the DBT arm, but an overall residual 16% excess of cancers remained (IRR 1.16 (1.04–1.30)). The initial increase in detection with DBT was consistent across most tumor types, except for large tumors (≥20 mm), grade 3, HER2-positive and triple-negative cancers. The reduction in detection after the second round was appreciable for large tumors and node-positive disease, but not for aggressive subtypes (hormone receptors (estrogen- and progesterone)-negative, HER2-positive, Ki-67 positive, triple-negative). Interpretation DBT likely detects tumours that would have presented as larger tumours in later screening rounds, particularly those with intrinsically favorable prognostic features.
(Less)
- author
- contributor
- Lang, Kristina
LU
- author collaboration
- organization
- publishing date
- 2026-05-02
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Breast cancer, Digital breast tomosynthesis, Digital mammography, Histological characteristics
- in
- European Journal of Cancer
- volume
- 238
- article number
- 116687
- pages
- 1 - 10
- publisher
- Elsevier
- external identifiers
-
- pmid:41895001
- scopus:105035488138
- ISSN
- 0959-8049
- DOI
- 10.1016/j.ejca.2026.116687
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © 2026 Elsevier Ltd.
- id
- 22a91b77-9ee6-4696-b47c-0b8754c6a2ca
- date added to LUP
- 2026-06-20 11:44:57
- date last changed
- 2026-10-27 01:20:21
@article{22a91b77-9ee6-4696-b47c-0b8754c6a2ca,
abstract = {{<p>Background Screening with digital breast tomosynthesis (DBT) detects more cancers than with digital mammography (DM), but has small effect, if any, on interval cancer incidence. Methods Data were pooled from two randomized trials within the MAITA Consortium, including 100743 women (664 cancers) screened at baseline and 82938 women (550 cancers) followed for cumulative incidence at subsequent round. At baseline, women were randomized to DBT+DM or DM alone; subsequent round used DM only. We compare the histological characteristics of cancers detected in women screened with DBT+DM versus DM alone, both at recruitment and after a negative screening result. No statistical tests are applied, except for interval cancers and cumulative incidence. Findings At the first round, the detection rate was 50% higher in the DBT arm compared to the DM arm. The overall incidence of interval cancers was similar in the two arms (IRR 0.95 (0.69-1.32)). At the subsequent round, the detection was 14% lower in the DBT arm, but an overall residual 16% excess of cancers remained (IRR 1.16 (1.04–1.30)). The initial increase in detection with DBT was consistent across most tumor types, except for large tumors (≥20 mm), grade 3, HER2-positive and triple-negative cancers. The reduction in detection after the second round was appreciable for large tumors and node-positive disease, but not for aggressive subtypes (hormone receptors (estrogen- and progesterone)-negative, HER2-positive, Ki-67 positive, triple-negative). Interpretation DBT likely detects tumours that would have presented as larger tumours in later screening rounds, particularly those with intrinsically favorable prognostic features.</p>}},
author = {{Mancuso, Pamela and Ragazzi, Moira and Castellano, Isabella and Iotti, Valentina and Frigerio, Alfonso and Sardanelli, Francesco and Vacondio, Rita and Campari, Cinzia and Fornasa, Francesca and Mantellini, Paola and Falini, Patrizia and Montemezzi, Stefania and Nitrosi, Andrea and Pattacini, Pierpaolo and Ponti, Antonio and Rossini, Gabriele and Segnan, Nereo and Armaroli, Paola and Rossi, Paolo Giorgi}},
issn = {{0959-8049}},
keywords = {{Breast cancer; Digital breast tomosynthesis; Digital mammography; Histological characteristics}},
language = {{eng}},
month = {{05}},
pages = {{1--10}},
publisher = {{Elsevier}},
series = {{European Journal of Cancer}},
title = {{Histological subtype and receptor characteristics of cancers detected or missed by digital mammography and tomosynthesis : Results from MAITA randomized trials}},
url = {{http://dx.doi.org/10.1016/j.ejca.2026.116687}},
doi = {{10.1016/j.ejca.2026.116687}},
volume = {{238}},
year = {{2026}},
}