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  • Open Access

Digital breast tomosynthesis: a comparison of the accuracy of digital breast tomosynthesis, two-dimensional digital mammography and two-dimensional screening mammography (film-screen)

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Breast Cancer Research200911 (Suppl 2) :O1

  • Published:


  • Final Outcome
  • Ongoing Study
  • Screening Mammography
  • Routine Screening
  • Local Research


Digital breast tomosynthesis (DBT) may improve the accuracy of mammography by enabling visual separation of overlapping tissues (Andersson et al. 2008, Poplack et al. 2007).


Following local research ethics approval, all women attending the assessment clinic for evaluation of a mammographic abnormality found on routine screening (film-screen) were invited to take part in the study subject to informed consent. Participants underwent bilateral two-view two-dimensional (2D) digital mammography and bilateral two-view DBT. Mammography scores using the RCR Breast Group classification were sequentially obtained for the screening mammogram, 2D digital and DBT, and these were each compared with the final assessment outcome.


Ninety-one percent of eligible women participated. Results from the first 300 participants are presented in Table 1 below.

Table 1


Imaging score

Screening mammogram

2D digital mammogram


Assessment outcome = normal or benign (n = 238)

M1 or M2

44 (18.4%)

130 (54.6%)

174 (73.1%)

Assessment outcome = malignant (n = 62)


22 (35.4%)

25 (40.3%)

33 (53.2%)

Indeterminate scores (M3) were assigned to 197 (65.7%) screening mammograms, 108 (36.0%) 2D digital mammograms and 62 (20.7%) DBT.

Kappa coefficients for agreement of each imaging method with final assessment outcome were calculated. Screening mammograms had the lowest agreement with the final outcome (Kappa = 0.02; P = 0.22), 2D digital mammography was better (Kappa = 0.26; P = 0.0000) and DBT had the highest score (Kappa = 0.37; P = 0.0000).


The preliminary results of this ongoing study show that DBT increases the diagnostic confidence of the radiologist. This supports the need for a larger multicentre study.

Authors’ Affiliations

Breast Radiology Department, King's College Hospital NHS Foundation Trust, London, UK
KCARE, Medical Engineering and Physics, King's College Hospital NHS Foundation Trust, London, UK
Department of Medical Statistics, King's College London, London, UK


© Michell et al; licensee BioMed Central Ltd. 2009

This article is published under license to BioMed Central Ltd.