Outcomes by Race in Breast Cancer Screening With Digital Breast Tomosynthesis Versus Digital Mammography.

Abstract Purpose Digital breast tomosynthesis (DBT) in conjunction with digital mammography (DM) is becoming the preferred imaging modality for breast cancer screening compared with DM alone, on the basis of improved recall rates (RR) and cancer detection rates (CDRs). The aim of this study was to investigate racial differences in the utilization and performance of screening modality. Methods Retrospective data from 63 US breast imaging facilities from 2015 to 2019 were reviewed. Screening outcomes were linked to cancer registries. RR, CDR per 1,000 examinations, and positive predictive value for recall (cancers/recalled patients) were compared. Results A total of 385,503 women contributed 542,945 DBT and 261,359 DM screens. A lower proportion of screenings for black women were performed using DBT plus DM (referred to as DBT) (44% for black, 48% for other, 63% for Asian, and 61% for Caucasian). Non-Caucasian women were less likely to undergo more than one mammographic examination. RRs were lower for DBT among all women (8.74 vs 10.06, P Conclusions All racial groups had improved outcomes with DBT screening, but disparities were observed in DBT utilization. These data suggest that reducing inequities in DBT utilization may improve the effectiveness of breast cancer screening.