Are additional spot views after tomosynthesis necessary?

Tomosynthesis has been shown to reduce recalls from screening mammography and to be equivalent to or better than conventional spot views. So how necessary are additional spot tomosynthesis views when women have been recalled after screening? Researchers from Yale University will address this question during this Tuesday session.

Dr. Jaime Geisel and colleagues performed a review of all BI-RADS 0 cases in women who had tomosynthesis between July and December 2013. Of a total 295 lesions, 157 lesions in 138 patients who had tomosynthesis spot views and ultrasound as part of their diagnostic workup were included. Two readers evaluated the screening tomosynthesis exam, the ultrasound images, and the additional diagnostic spot tomosynthesis views, for a total of 314 lesion assessments.

Although 72% of spot tomosynthesis views did not add further diagnostic information after screening mammography, there were some types of findings for which the views helped more -- namely, architectural distortions and lesions found on only one view at screening, according to the researchers.

The study led Geisel and colleagues to conclude that routine screening tomosynthesis views offer adequate assessment of most mammographic findings, so ultrasound alone can be used to work up the majority of recalls, which saves money and time and reduces women's radiation exposure.