Randomized trial comparing the performance of tomosynthesis and 2D Digital Mammography vs 2D Digital Mammography only in respect to incidence of advanced cancers (interval and following round) and interval cancers.
The investigators conduct a randomized trial (about 20000 tests in the intervention arm) comparing the performance of tomosynthesis plus 2D Digital Mammography vs usual care (2D digital mammography) in respect to incidence of advanced cancers (interval and following round) and interval cancers. The investigators also will measure detection rates, specificity, interval cancers, advanced cancers occurring as interval cancers or at subsequent screens and allowing to estimate overdiagnosis. In Reggio Emilia a population-based screening program is active. It invites all women from 45 to 74 years old for a 2D digital mammography (2 projections, double reading) every 2 years (annually from 45 to 49). Women will be asked for informed consent when they attend the mammography. I they accept they will be randomised to one of the two arms. All examinations will be read by two independent radiologists, in case of discordance a third reading is asked.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SCREENING
Enrollment
26,877
twice screening examination: standard 2D mammography + Digital Breast Tomosynthesis
Azienda Sanitaria Locale Reggio Emilia
Reggio Emilia, Italy
cumulative incidence of T2+ cancers after screening
Time frame: 2 years
incidence of interval cancers
Time frame: 2 years
Detection rate
Time frame: 2 years
recall rate
Time frame: baseline
Positive Predictive value
Time frame: baseline
diagnostic agreement between tomosynthesis and 2d mammography
Time frame: baseline
Detection rate of in situ ductal carcinoma
Time frame: 2 years
biopsy rate
Time frame: baseline
self-reported pain and discomfort during mammography
Time frame: baseline
x-ray dose
Time frame: baseline
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