Evidence map›Paper›PMID 33372954›Full record

SynthesisJournal of the National Cancer Institute2021

Performance of Digital Breast Tomosynthesis, Synthetic Mammography, and Digital Mammography in Breast Cancer Screening: A Systematic Review and Meta-Analysis.

Mostafa Alabousi, Akshay Wadera, Mohammed Kashif Al-Ghita, Rayeh Kashef Al-Ghetaa, Jean-Paul Salameh, Alex Pozdnyakov, Nanxi Zha, Lucy Samoilov, Anahita Dehmoobad Sharifabadi, Behnam Sadeghirad and 3 more

Open access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of the National Cancer Institute, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 4 pooled it
6.5field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 4 syntheses or guidelines pooled it, 90 citations in OpenAlex.

  1. Guideline
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  15. Journal of medical imaging (Bellingham, Wash.) · 2025
    Article
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  20. Breast cancer: Epidemiology, risk factors and screening.Chinese journal of cancer research = Chung-kuo yen cheng yen chiu · 2023
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 5 institutions in 1 country.

Mostafa AlabousiDepartment of Radiology, McMaster University, Hamilton, ON, Canada.
Akshay WaderaDepartment of Radiology, McMaster University, Hamilton, ON, Canada.
Mohammed Kashif Al-GhitaFaculty of Biomedical Sciences, Western University, London, ON, Canada.
Rayeh Kashef Al-GhetaaInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Jean-Paul SalamehDepartment of Radiology, University of Ottawa, Ottawa, ON, Canada.
Alex PozdnyakovFaculty of Medicine, McMaster University, Hamilton, ON, Canada.
Nanxi ZhaDepartment of Radiology, McMaster University, Hamilton, ON, Canada.
Lucy SamoilovDepartment of Radiology, McMaster University, Hamilton, ON, Canada.
Anahita Dehmoobad SharifabadiDepartment of Radiology, McMaster University, Hamilton, ON, Canada.
Behnam SadeghiradDepartment of Health Research Methods, Evidence, and Impact (HEI), The Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, ON, Canada.
Vivianne FreitasJoint Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
Matthew Df McInnesDepartment of Radiology and Epidemiology, University of Ottawa, Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, ON, Canada.
Abdullah AlabousiDepartment of Radiology, McMaster University, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada.
McMaster University · CAUniversity of Toronto · CAOttawa Hospital Research InstituteUniversity of Ottawa · CAWestern University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOur objective was to perform a systematic review and meta-analysis comparing the breast cancer detection rate (CDR), invasive CDR, recall rate, and positive predictive value 1 (PPV1) of digital mammography (DM) alone, combined digital breast tomosynthesis (DBT) and DM, combined DBT and synthetic 2-dimensional mammography (S2D), and DBT alone.

methodsMEDLINE and Embase were searched until April 2020 to identify comparative design studies reporting on patients undergoing routine breast cancer screening. Random effects model proportional meta-analyses estimated CDR, invasive CDR, recall rate, and PPV1. Meta-regression modeling was used to compare imaging modalities. All statistical tests were 2-sided.

resultsForty-two studies reporting on 2 606 296 patients (13 003 breast cancer cases) were included. CDR was highest in combined DBT and DM (6.36 per 1000 screened, 95% confidence interval [CI] = 5.62 to 7.14, P < .001), and combined DBT and S2D (7.40 per 1000 screened, 95% CI = 6.49 to 8.37, P < .001) compared with DM alone (4.68 per 1000 screened, 95% CI = 4.28 to 5.11). Invasive CDR was highest in combined DBT and DM (4.53 per 1000 screened, 95% CI = 3.97 to 5.12, P = .003) and combined DBT and S2D (5.68 per 1000 screened, 95% CI = 4.43 to 7.09, P < .001) compared with DM alone (3.42 per 1000 screened, 95% CI = 3.02 to 3.83). Recall rate was lowest in combined DBT and S2D (42.3 per 1000 screened, 95% CI = 37.4 to 60.4, P<.001). PPV1 was highest in combined DBT and DM (10.0%, 95% CI = 8.0% to 12.0%, P = .004), and combined DBT and S2D (16.0%, 95% CI = 10.0% to 23.0%, P < .001), whereas no difference was detected for DBT alone (7.0%, 95% CI = 6.0% to 8.0%, P = .75) compared with DM alone (7.0%, 95.0% CI = 5.0% to 8.0%).

conclusionsOur findings provide evidence on key performance metrics for DM, DBT alone, combined DBT and DM, and combined DBT and S2D, which may inform optimal application of these modalities for breast cancer screening.

Indexed as

Breast NeoplasmsEarly Detection of CancerBreastFemaleHumansMammographyMass ScreeningPredictive Value of TestsRetrospective Studies

Identifiers

PMID33372954
PMCPMC8168096
OpenAlexW3116889151

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.