(HealthDay News) — Compared with digital mammography alone, the combination of digital mammography and tomosynthesis increases cancer detection and reduces false-positive results, according to research published in the Journal of the American Medical Association.

Sarah M. Friedewald, MD, of the Advocate Lutheran General Hospital in Park Ridge, IL, and colleagues conducted a retrospective analysis of data from 281,187 digital mammography examinations and 173,663 digital mammography plus tomosynthesis examinations to assess their performance in breast screening programs.

The researchers found that, using model-adjusted rates per 1,000 screens, for digital mammography versus digital mammography plus tomosynthesis, respectively, the recall rate was 107 (95% confidence interval [CI], 89 to 124) versus 91 (95% CI, 73 to 108; difference, −16; 95% CI, −18 to −14; P < 0.001).

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The biopsy rate was 18.1 (95% CI, 15.4 to 20.8) versus 19.3 (95% CI, 16.6 to 22.1; difference, 1.3; 95% CI, 0.4 to 2.1; P = 0.004); and the cancer detection rate was 4.2 (95% CI, 3.8 to 4.7) versus 5.4 (95% CI, 4.9 to 6.0; difference, 1.2; 95% CI, 0.8 to 1.6; P < 0.001).

“[T]omosynthesis is likely an advance over digital mammography for breast cancer screening, but fundamental questions about screening remain, with all available technologies,” wrote the authors of an accompanying editorial.

Several authors disclosed financial ties to Hologic, a company that manufactures tomosynthesis equipment. The authors of the editorial also disclosed financial ties to companies that manufacture mammography screening equipment.


  1. Friedewald SM, Rafferty EA, Rose SL et al. Breast Cancer Screening Using Tomosynthesis in Combination With Digital Mammography. JAMA. 2014;311(24):2499-2507.
  2. Pisano ED, Yaffe MJ. Breast Cancer Screening: Should Tomosynthesis Replace Digital Mammography? JAMA. 2014;311(24):2488-2489.