Diagnostic performance of tomosynthesis plus synthetic mammography versus full‐field digital mammography with or without tomosynthesis in breast cancer screening: A systematic review and meta‐analysis
2025

Comparing Tomosynthesis Plus Synthetic Mammography to Digital Mammography in Breast Cancer Screening

Sample size: 452218 publication 10 minutes Evidence: moderate

Author Information

Author(s): Wasim Hamad, Michael J. Michell, Jonathan P. Myles, Fiona J. Gilbert, Yan Chen, Huajie Jin, John Loveland, Mark Halling‐Brown, Keshthra Satchithananda, Juliet Morel, Asif Iqbal, Rema Wasan, Caroline Taylor, Nisha Sharma, Alexandra Valencia, Will Teh, Faisal Majid, Ronald M De Visser, Stephen W. Duffy

Primary Institution: Queen Mary University of London

Hypothesis

How does the performance of synthetic 2D mammography combined with digital breast tomosynthesis compare to full-field digital mammography in breast cancer screening?

Conclusion

Tomosynthesis plus synthetic mammography improves cancer detection rates compared to full-field digital mammography alone while reducing radiation exposure.

Supporting Evidence

  • DBT plus S2D showed a higher cancer detection rate compared to FFDM alone.
  • DBT plus S2D maintained similar accuracy to DBT plus FFDM while reducing radiation exposure.
  • Specificity was significantly higher for DBT plus S2D compared to DBT plus FFDM.

Takeaway

Using a special type of breast scan called tomosynthesis with a synthetic image can find more cancers than the regular scan, and it uses less radiation.

Methodology

A systematic review and meta-analysis were conducted, including studies that evaluated the performance of synthetic 2D mammography either alone or in combination with other modalities for breast cancer detection.

Potential Biases

Most studies were not randomized, which may introduce bias in the results.

Limitations

The review did not include studies on synthetic mammography alone due to insufficient data, and most included studies were not randomized, which may increase bias risks.

Participant Demographics

All studies included asymptomatic participants from breast cancer screening settings.

Statistical Information

P-Value

p=0.06 for specificity comparison

Confidence Interval

95% CI 0.81–3.25 for CDR difference; 95% CI 0.59–1.56 for specificity difference

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1002/ijc.35217

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