From the November 2018 issue of HealthCare Business News magazine
Among women recalled for further testing, those screened with DBT had a more streamlined diagnostic workflow, as 15.1 percent of recalls after DBT did not include diagnostic mammography, compared to only 3.9 percent for 2D alone. In addition, those recalled after DBT experienced a faster time to biopsy, with the average being 19 days with DBT, compared to 23 days with 2D; and faster time to diagnosis as well, averaging 10 days with DBT, compared to 13 days with 2D. While these findings persisted in all age groups, races and breast densities across both health systems, they were more pronounced in facilities performing predominantly DBT screening, demonstrating DBT not only offers a more efficient screening option, but that increasing its utilization is associated with improved resource utilization profile.
DBT also helped physicians find smaller, earlier-stage cancers, which are easier to treat and would have been missed on 2D mammograms. Despite DBT’s superiority compared to 2D alone, the USPSTF still maintains an insufficient rating in the 2015 USPSTF Breast Cancer Screening guidelines, due in part to a lack of studies with sufficient follow-up information needed to calculate sensitivity and specificity. To address this, the study analyzed the largest number of DBT exams ever in a single study, and found DBT increased both sensitivity and specificity when compared to 2D alone, thus filling this gap in evidence.
Facilities looking to both exceed performance benchmarks and deliver exceptional patient care should look toward adopting and fully implementing screening DBT. Facilities that predominantly perform DBT experience lower recall rates, and among those recalled, experience decreased utilization of diagnostic mammography, faster time to biopsy, and faster time to final diagnostic resolution. With all of these proven clinical benefits in mind, facilities with low utilization should prioritize increasing these rates in order to maximize the full benefits of DBT usage for both the practice, and the patient.
About the Author: Dr. Nila H. Alsheik is a diagnostic radiologist at Advocate Lutheran General Hospital in Park Ridge, Illinois.
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