Effectiveness of digital breast tomosynthesis (3D-mammography) in population breast cancer screening : A protocol for a collaborative individual participant data (IPD) meta-analysis
(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.
(Less)
- author
- Houssami, Nehmat ; Lång, Kristina LU ; Hofvind, Solveig ; Zackrisson, Sophia LU ; Bernardi, Daniela ; Hunter, Kylie ; Askie, Lisa and Skaane, Per
- organization
- publishing date
- 2017-08-01
- 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
- 2024-03-17 21:57:57
@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}},
keywords = {{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}},
doi = {{10.21037/tcr.2017.06.39}},
volume = {{6}},
year = {{2017}},
}