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Cancer Screening, Diagnosis and Care

European guidelines on breast cancer screening and diagnosis


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5. Use of tomosynthesis

Screening with tomosynthesis plus mammography vs. mammography alone

Issued on: June 2021

Healthcare question

Should screening using digital breast tomosynthesis in addition to digital mammography vs. digital mammography alone be used in organised screening programmes for early detection of breast cancer in asymptomatic women?

Recommendation

For asymptomatic women with an average risk of breast cancer, the ECIBC's Guidelines Development Group (GDG) suggests not using both digital breast tomosynthesis (DBT) and digital mammography (DM) in the context of an organised population-based screening programme.

Recommendation strength

Conditional recommendation
Very low certainty of the evidence

Justification

The decision on this recommendation takes into account what was decided for the recommendation on DBT vs DM (conditional for either DBT or DM) and the fact the radiation dose would be doubled using both technologies. Moreover, the GDG judged that the resources required are large and may vary based on the healthcare setting and funding, which may lead to increased health inequities across Europe.

Subgroup considerations

The GDG developed a specific recommendation on the use of DBT as an additional test for women with high mammographic breast density detected for the first time with digital mammography. See recommendation ‘Tailored screening in women with high breast density: Digital breast tomosynthesis'. 

Monitoring and evaluation

The inappropriate use of screening strategies requiring double radiation exposure should be monitored.

Research priorities

The GDG noted how, in the absence of unforeseen development of the technology, future research should focus on screening strategies requiring single radiation exposure. 

Supporting material

yes