Screening programmes play a crucial role in early breast cancer detection and mammography remains the best method to detect breast cancer at an early stage.

Digital mammography is an imaging technique that creates a 2D image of the breast. Digital breast tomosynthesis is a pseudo-3D imaging technique based on a series of low dose images of the breast from different angles that has the potential to overcome the tissue superposition issue, thus improving detection of breast lesions.

Healthcare question

Should screening using digital breast tomosynthesis vs. digital mammography 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 using either digital breast tomosynthesis (DBT) or digital mammography (DM) in the context of an organised screening programme.

Recommendation strength ­

  Conditional recommendation for either the intervention or the comparison

  Very low certainty of the evidence

Justification

The GDG agreed this recommendation by consensus with no need for voting.

The decision on this recommendation takes into account the balance between desirable and undesirable effects that probably favours DBT, but in the context of very low certainty of the evidence and absence of data regarding the downstream impact of the interventions on mortality and morbidity. New studies reporting data on resource use and cost effectiveness seem to favour DM in several settings, with an increased certainty of the evidence of resources required.

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