LAUSR

Ho and colleagues 1 examine whether use of digital breast tomosynthesis (DBT), termed 3D mammography bysomecliniciansandpatients,isassociatedwithalowerprobabilityoffalse-positive results over 10 years of screening compared with digital mammography. The authors used prospectively collected data from approximately 1 million women and almost 3 million mammograms performed at 126 radiology facilities participating in the Breast Cancer Surveillance Consortium to examine screening round–specific false-positive events (including recall for further imaging, short-interval follow-up recommendations, and biopsy recommendations) and cumulative false-positive event rates associated with annual or biennial screening with digital mammography or DBT, adjusting for age and breast density. The authors found that DBT was associated with fewer recalls for false-positive results over a 10-year study period, although the difference was modest: 10-year rates were 56.3% for annual screening with digital mammography vs 49.6% with annual DBT. Differences between DBT and digital mammography were smaller for short-interval follow-up and biopsy recommendations. Moreover, screening interval, age, and breast density were associated more than screening modality with false-positive rates. For women with the highest degree of breast density (ie, extremely dense breasts), false-positive rates were similar for DBT and digital mammography. Much of what we know about the benefits and harms of mammography screening has come from studies of mammography technology that is no longer widely used (eg, plain film mammography), raising concerns that these estimates are not relevant for women undergoing mammograms today. Digital breast tomosynthesis, now widely used in the US, 2 has been associated withincreasedcancerdetectionanddecreasedrecallrates, 3 leadingtooptimismthatDBTscreening could lead to a more favorable ratio of benefits (ie, early detection of clinically meaningful breast cancers and ultimately reduced breast cancer mortality) to harms (including false-positive results). A previous multicenter study 4 also suggested that women with dense breasts might