22 May Family History of Breast Cancer: Study Compares Tomosynthesis vs Mammography
MedicalResearch.com Interview with:
Dr Tong Li
Dr Tong Li PhD | Cancer Institute NSW Early Career Fellow
Breast Cancer Clinical and Population Health Stream
The Daffodil Centre, Faculty of Medicine and Health, The University of Sydney
Moore Theological College | The University of Sydney | NSW | 2042
MedicalResearch.com: What is the background for this study?
Response: Having a family history of breast cancer is one of the most common risk factors for women. About 8% to 11% of women in the U.S. report having a close relative diagnosed with breast cancer. These women often have dense breasts. Dense breast tissue can make standard digital mammography (DM, also known as 2D mammography) less effective in detecting cancer. Digital breast tomosynthesis (DBT), a 3D imaging technology, has become increasingly used in breast cancer screening because it improves the visibility of lesions and reduces unnecessary callbacks. However, until now, it has been unclear whether DBT offers the same benefits in women with a family history of breast cancer, especially across different family risk levels and breast density types.
MedicalResearch.com: What are the main findings?
Response: Our study analyzed over 500,000 screening exams and is the largest to date comparing DBT and DM in women with a family history of breast cancer. The study found that DBT:
- Reduced recall rates and increased specificity, meaning fewer unnecessary investigation or work-up/callbacks, and more accurate identification of women without cancer.
- Maintained effective cancer detection, with similar ability to find cancer early as DM despite less recall.
- Showed the most benefit in women who had:
- One first-degree relative with breast cancer
- Scattered fibroglandular breast density
- Ages under 40 or between 60 and 69 years
- Repeat screening exams (not first-time screens)
- Reduced rates of advanced cancers in women with extremely dense breasts— meaning more aggressive (or potentially larger) tumors are found at an earlier stage.
MedicalResearch.com: What should readers take away from your report?
Response: For practicing clinicians, this study offers strong evidence that DBT may be a better screening option than DM for women with a family history of breast cancer. It improves specificity and reduces recalls—important in minimizing patient anxiety and avoiding unnecessary follow-up tests—while maintaining cancer detection performance. These results support the use of DBT, especially in women with dense breasts or those with a first-degree relative diagnosed with breast cancer.
MedicalResearch.com: What recommendations do you have for future research as a results of this study?
Response: To refine screening strategies and maximize clinical benefit, future research could:
- Refine screening guidelines to tailor use of DBT based on degree and numbers tomof affected relatives, and breast density.
- Support development of personalized screening guidelines that factor in family history, breast density, age, and screening history to guide optimal imaging decisions.
Any disclosures?
This study is a collaborative effort between The University of Sydney (Australia) and the Breast Cancer Surveillance Consortium (United States).
Citation:
Li TSu YLee JM, et al. Tomosynthesis vs Digital Mammography Screening in Women with a Family History of Breast Cancer. JAMA Oncol. Published online May 22, 2025. doi:10.1001/jamaoncol.2025.1209
https://jamanetwork.com/journals/jamaoncology/fullarticle/2834386
More information:
- American College of Obstetricians and Gynecologists (ACOG). (2020). Digital Breast Tomosynthesis. ACOG Technology Assessment
https://www.acog.org/clinical/clinical-guidance/technology-assessment/articles/2013/06/digital-breast-tomosynthesis| - Pacifici, S., Campos, A., Murphy, A., et al. (2024). Digital breast tomosynthesis. Radiopaedia.org. doi: 10.53347/rID-15235.
https://radiopaedia.org/articles/digital-breast-tomosynthesis?lang=us
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Last Updated on May 23, 2025 by Marie Benz MD FAAD
