A statistical analysis of the study data showed breast density assignments varied greatly by the screening method used.
"We observed an overall trend of downgraded breast density when imaging was performed with either DM/DBT or SM/DBT compared with DM alone," Dr. Gastounioti said. "These effects were more prominent among African-American women and women with higher BMI."
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Compared to standard DM imaging, the odds of a high-density assessment were reduced by 31 percent and 57 percent respectively when mammographic imaging was performed with DM/DBT or SM/DBT. The odds of receiving a high breast density assignment after SM replaced DM were reduced by 38 percent.
The density downgrade may be due to the perception of less fibroglandular tissue in the 3-D display of DBT imaging compared to DM's flat, 2-D display, as well as differences in the appearance of the denser glandular tissue and the fatty tissue in the reconstructed SM imaging.
"Our findings may have direct implications for personalized screening since breast density assignments, which often drive recommendations for supplemental screening, may vary greatly by modality, race and BMI," Dr. Gastounioti said.
She added that further research is needed to determine whether BI-RADS guidelines need to be adjusted for new imaging modalities.
"Effect of Mammographic Screening Modality on Breast Density Assessment: Digital Mammography versus Digital Breast Tomosynthesis." Collaborating with Dr. Gastounioti were Anne Marie McCarthy, Ph.D., Lauren Pantalone, B.S., Marie Synnestvedt, Ph.D., Despina Kontos, Ph.D., and Emily F. Conant, M.D.
The study was supported by the Susan G. Komen for the Cure Breast Cancer Foundation and the National Cancer Institute at the National Institutes of Health.
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