2D mammography, digital breast tomosynthesis, and ultrasound: which should be used for the different breast densities in breast cancer screening?

PurposeTo determine which modalities [2D mammography (2D), digital breast tomosynthesis (DBT), whole breast sonography (WBS)] are optimal for screening depending on breast density.MethodsInstitutional retrospective cohort study of 2013 screening mammograms (16,789), sorted by modalities and density.ResultsCancer detection is increased by adding WBS to 2D (P = .02) for the overall study population. Recall rate was lowest with 2D + DBT (10.2%, P < .001) and highest with 2D + DBT + WBS (23.6%, P < .001) for the overall study population as well.ConclusionWomen with dense and nondense breasts benefit from reduced recall rate with the addition of DBT; however, this benefit is negated with the addition of WBS.