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Breast tomosynthesis: a fine balance between benefits and harms in breast cancer screening

Meagan E Brennan
Med J Aust 2019; 211 (8): . || doi: 10.5694/mja2.50359
Published online: 21 October 2019

Many questions need to be discussed before 3D‐mammography is adopted for standard screening

In this issue of the MJA, Houssami and colleagues report the first prospective trial of breast tomosynthesis screening in the Australian BreastScreen program. They found that tomosynthesis has a higher cancer detection rate (CDR) than standard mammography; the trade‐offs were a higher recall rate, higher radiation dose, and longer reading time.1


  • 1 Northern and Westmead Clinical Schools, University of Sydney, Sydney, NSW
  • 2 The University of Notre Dame, Sydney, NSW



Competing interests:

No relevant disclosures.

  • 1. Houssami N, Lockie D, Clemson M, et al. Pilot trial of digital breast tomosynthesis (3D mammography) for population‐based screening in BreastScreen Victoria. Med J Aust 2019; 211: 357–362.
  • 2. Marinovich ML, Hunter KE, Macaskill P, Houssami N. Breast cancer screening using tomosynthesis or mammography: a meta‐analysis of cancer detection and recall. J Natl Cancer Inst 2018; 110: 942–949.
  • 3. Jacklyn G, Glasziou P, Macaskill P, Barratt A. Meta‐analysis of breast cancer mortality benefit and overdiagnosis adjusted for adherence: improving information on the effects of attending screening mammography. Br J Cancer 2016; 114: 1269–1276.
  • 4. Carter JL, Coletti RJ, Harris RP. Quantifying and monitoring overdiagnosis in cancer screening: a systematic review of methods. BMJ 2015; 350: g7773.
  • 5. BreastScreen Australia. BreastScreen Australia National Accreditation Standards. Updated 16 Jan 2019. http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/CA8C934AA0B7BA64CA257EFA001C67D7/$File/BSA%20NAS%20Commentary%20January%202019%20FINAL.pdf (viewed July 2019).
  • 6. Hersch J, Jansen J, McCaffery K. Decision‐making about mammographic screening: pursuing informed choice. Climacteric 2018; 21: 209–213.
  • 7. Brennan M, Houssami N. Discussing the benefits and harms of screening mammography. Maturitas 2016; 92: 150–153.

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