Mammography has a low positive predictive value. Studies show mammography leads to unnecessary follow-up procedures — such as handheld ultrasound or MRI imaging and biopsies — leading to unnecessary patient anxiety, costs, and time.
For every 1,000 screening mammograms, 150 women are called back for more tests. Of those 150 women, 15 have a biopsy and only 3 are diagnosed with cancer. These unnecessary callbacks and procedures are largely due to the limitations of mammography, both in terms of sensitivity and specificity, particularly for common benign breast cysts, dense breasts, and women under 40.
150 Women Called Back
~15% call-backs rates with mammography
15 Women Are Biopsied
~10% biopsy rate for callbacks
3 Women Diagnosed
0.3% cancer diagnosis5
98% of recalls
are avoidable
Over 80% of callback
biopsies are benign3
Overtreatment of DCIS Cancers
Screening mammography may also lead to overdiagnosis and overtreatment of slow-growing ductal carcinoma in situ (DCIS) cancers, which may not impact a patient’s lifespan. This is particularly a problem with 2D digital X-ray mammography, where overlapping fibroglandular tissues in 2D can obscure or mimic lesions. And these mammography limitations are further exacerbated for women with dense breasts and/or breast implants.
A recent exploratory multi-reader, multi-case study retrospectively evaluated radiologists’ performance of non-cancer recall rates and lesion detection rates using QTI’s Breast Acoustic CT™ platform versus 2D digital mammography in a cross section of 108 breast cases (42 normal, 39 pathologically-confirmed benign, and 27 pathology-confirmed cancer). The study found QTscans significantly decreased the mean non-cancer recall rate by 16%, at the expense of a 2% decrease in the mean cancer recall rate.
XRM
QTI – Speed of Sound
Similarly, a recent multi-reader, multi-case study prospectively compared radiologists’ interpretation of QTI Breast Acoustic CT™ platform versus DBT for 177 breast cases (66 with cancer/atypia/solid mass and 111 normal/nonsolid benign abnormality) — demonstrating that QTI is also noninferior to digital breast tomosynthesis (DBT) in terms of receiver operating characteristics (ROC) and area under the curve (AUC) analyses.
The study also showed specificity was much higher for QTI (60.1%) than DBT (37.2%), indicating that QTI can better differentiate benign from malignant lesions.
- 1 3-D Nonlinear Acoustic Inverse Scattering: Algorithm and Quantitative Results, IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
- 3 Breast Biopsy: Procedure Types, What to Expect and Results, National Breast Cancer Foundation
- 4 U.S. Breast Cancer Statistics, Breastcancer.org
- 5 B. Malik, R. Terry, J. Wiskin, and M. Lenox, Quantitative Transmission Ultrasound Tomography: Imaging and Performance Characteristics, Medical Physics, published 2019
- Jiang Y, Iuanow E, Malik B, Klock J. A Multireader Multicase (MRMC) Receiver Operating Characteristic (ROC) Study Evaluating Noninferiority of Quantitative Transmission (QT) Ultrasound to Digital Breast Tomosynthesis (DBT) on Detection and Recall of Breast Lesions. Acad Radiol. 2024 Jun;31(6):2248-2258. doi: 10.1016/j.acra.2023.12.038. Epub 2024 Jan 29. PMID: 38290888.
- Malik B, Iuanow E, Klock J. An Exploratory Multi-reader, Multi-case Study Comparing Transmission Ultrasound to Mammography on Recall Rates and Detection Rates for Breast Cancer Lesions. Acad Radiol. 2022 Jan;29 Suppl 1:S10-S18. doi: 10.1016/j.acra.2020.11.011. Epub 2020 Dec 3. PMID: 33281042.
- Gram EG, Siersma V, Brodersen JB. Long-term psychosocial consequences of false-positive screening mammography: a cohort study with follow-up of 12-14 years in Denmark. BMJ Open. 2023 Apr 26;13(4):e072188. doi: 10.1136/bmjopen-2023-072188. PMID: 37185642; PMCID: PMC10151842.
- Tosteson AN, Fryback DG, Hammond CS, Hanna LG, Grove MR, Brown M, Wang Q, Lindfors K, Pisano ED. Consequences of false-positive screening mammograms. JAMA Intern Med. 2014 Jun;174(6):954-61. doi: 10.1001/jamainternmed.2014.981. PMID: 24756610; PMCID: PMC4071565.