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Effectiveness of digital breast tomosynthesis (3D-mammography) in population breast cancer screening : A protocol for a collaborative individual participant data (IPD) meta-analysis

Houssami, Nehmat; Lång, Kristina LU ; Hofvind, Solveig; Zackrisson, Sophia LU ; Bernardi, Daniela; Hunter, Kylie; Askie, Lisa and Skaane, Per (2017) In Translational Cancer Research 6(4). p.869-877
Abstract

Background: There is accumulating evidence that digital breast tomosynthesis, referred to as 3D-mammography in this protocol, improves screen-detection measures compared to standard 2D-mammography in the context of population screening for breast cancer. However, the effect of 3D-mammography at follow-up of screened women is not yet known: it is unknown whether additional cancer detection from 3D-mammography leads to incremental screening benefit through a reduction of interval cancers, or whether it is mostly over-detecting indolent cancers. Methods: The aim of this study is to examine whether 3D-mammography population screening improves breast cancer screening effectiveness by reducing interval cancer rates compared to standard... (More)

Background: There is accumulating evidence that digital breast tomosynthesis, referred to as 3D-mammography in this protocol, improves screen-detection measures compared to standard 2D-mammography in the context of population screening for breast cancer. However, the effect of 3D-mammography at follow-up of screened women is not yet known: it is unknown whether additional cancer detection from 3D-mammography leads to incremental screening benefit through a reduction of interval cancers, or whether it is mostly over-detecting indolent cancers. Methods: The aim of this study is to examine whether 3D-mammography population screening improves breast cancer screening effectiveness by reducing interval cancer rates compared to standard digital (2D) mammography screening, using individual participant data (IPD) meta-analysis. In this protocol, we outline the research plan which includes systematic identification of studies eligible to contribute data into the IPD meta-analysis, and sourcing and assembling IPD for participants screened with 3D-mammography (3D alone or integrated 2D/3D or integrated 2Dsynthetic/3D) and comparison participants screened with 2D-mammography (standard of care in breast screening). The primary end-point of this work is the interval breast cancer rate per 10,000 screens for 3D-mammography versus 2D-mammography screening. The IPD meta-analysis will also assess secondary outcomes including: screening sensitivity, cancer detection rates, cancer (prognostic) characteristics, and recall rates, for 3D-mammography versus 2D-mammography screening. The use of IPD meta-analysis will allow stratification of results by age and breast density, and will also facilitate analysis of cancer histological (prognostic) characteristics. Discussion: Finalization of data collection procedures and analysis plans will be complete by the end of 2017. Data collection will occur from late 2017 to late 2018 (screen-detection measures: cancer detection and recall data) and from mid-2018 to mid-2019 (interval cancer data). Results of detection measures should be available by 2019, and interval cancer results in 2020. By addressing the critical evidence gap on whether 3D-mammography screening reduces interval cancer rates (compared to 2D-mammography), we expect that our findings will inform timely translation of 3D-mammography technology into breast screening practice in population-based health programs.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Breast neoplasms, Mammography, Mass screening
in
Translational Cancer Research
volume
6
issue
4
pages
9 pages
publisher
AME Publishing Company
external identifiers
  • scopus:85028561704
  • wos:000409349600022
ISSN
2218-676X
DOI
10.21037/tcr.2017.06.39
language
English
LU publication?
yes
id
2d4f638b-bbbf-47a4-8fa3-46498fea01c8
date added to LUP
2017-10-04 15:31:23
date last changed
2018-01-16 13:20:43
@article{2d4f638b-bbbf-47a4-8fa3-46498fea01c8,
  abstract     = {<p>Background: There is accumulating evidence that digital breast tomosynthesis, referred to as 3D-mammography in this protocol, improves screen-detection measures compared to standard 2D-mammography in the context of population screening for breast cancer. However, the effect of 3D-mammography at follow-up of screened women is not yet known: it is unknown whether additional cancer detection from 3D-mammography leads to incremental screening benefit through a reduction of interval cancers, or whether it is mostly over-detecting indolent cancers. Methods: The aim of this study is to examine whether 3D-mammography population screening improves breast cancer screening effectiveness by reducing interval cancer rates compared to standard digital (2D) mammography screening, using individual participant data (IPD) meta-analysis. In this protocol, we outline the research plan which includes systematic identification of studies eligible to contribute data into the IPD meta-analysis, and sourcing and assembling IPD for participants screened with 3D-mammography (3D alone or integrated 2D/3D or integrated 2Dsynthetic/3D) and comparison participants screened with 2D-mammography (standard of care in breast screening). The primary end-point of this work is the interval breast cancer rate per 10,000 screens for 3D-mammography versus 2D-mammography screening. The IPD meta-analysis will also assess secondary outcomes including: screening sensitivity, cancer detection rates, cancer (prognostic) characteristics, and recall rates, for 3D-mammography versus 2D-mammography screening. The use of IPD meta-analysis will allow stratification of results by age and breast density, and will also facilitate analysis of cancer histological (prognostic) characteristics. Discussion: Finalization of data collection procedures and analysis plans will be complete by the end of 2017. Data collection will occur from late 2017 to late 2018 (screen-detection measures: cancer detection and recall data) and from mid-2018 to mid-2019 (interval cancer data). Results of detection measures should be available by 2019, and interval cancer results in 2020. By addressing the critical evidence gap on whether 3D-mammography screening reduces interval cancer rates (compared to 2D-mammography), we expect that our findings will inform timely translation of 3D-mammography technology into breast screening practice in population-based health programs.</p>},
  author       = {Houssami, Nehmat and Lång, Kristina and Hofvind, Solveig and Zackrisson, Sophia and Bernardi, Daniela and Hunter, Kylie and Askie, Lisa and Skaane, Per},
  issn         = {2218-676X},
  keyword      = {Breast neoplasms,Mammography,Mass screening},
  language     = {eng},
  month        = {08},
  number       = {4},
  pages        = {869--877},
  publisher    = {AME Publishing Company},
  series       = {Translational Cancer Research},
  title        = {Effectiveness of digital breast tomosynthesis (3D-mammography) in population breast cancer screening : A protocol for a collaborative individual participant data (IPD) meta-analysis},
  url          = {http://dx.doi.org/10.21037/tcr.2017.06.39},
  volume       = {6},
  year         = {2017},
}