Mitchell Schnall, co-chair of the ECOG-ACRIN trial group, told HCB News that the trial is essential to improving the process of identifying high-risk patients and learning how to better utilize both technologies. “One size should not fit all in breast cancer screening, and the TMIST trial can show the way to a precision approach to screening. Look, we all know that 3D sees more lesions, but consequently, more women are having additional procedures, including biopsies and excisions. The question that TMIST asks is whether that huge expenditure of time, money, and psychological stress are worth it in terms of better outcomes for each person who has the experience. We need this trial to help us learn how to improve the process for identifying high-risk patients and how to utilize both of these technologies better."

Dr. Daniel Kpans, professor of radiology at Harvard University, who was involved with developing the first 3D unit, told Medscape Medical News earlier this year that TMIST was a “huge waste of money. Radiologists who are experienced in using [3-D] for screening will not go back. It would be malpractice since they know there are cancers that they will miss on 2D that they can find on tomosynthesis.”

NCI director Dr. Ned Sharpless also weighed in on the issues surrounding TMIST during the meeting. "There is no easy way to do this. TMIST is the most troubled of our trials [in prevention and screening] from an accrual point of view.”

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