Digital Breast Tomosynthesis Utilization in the United States: A Survey of Physician Members of the Society of Breast Imaging

J Am Coll Radiol. 2016 Nov;13(11S):R67-R73. doi: 10.1016/j.jacr.2016.09.030.


Purpose: To assess utilization of digital breast tomosynthesis (DBT) and examine criteria for offering DBT to patients.

Methods: We created an online survey for physician members of the Society of Breast Imaging to assess their use of DBT. The questions covered availability of DBT at the participant's practice, whether DBT was used for clinical care or research, clinical decision rules guiding patient selection for DBT, costs associated with DBT, plans to obtain DBT, and breast imaging practice characteristics. Fisher's exact tests and logistic regression were used to compare DBT users and nonusers.

Results: In all, 670 members responded (response rate = 37%). Of these, 200 (30.0%) respondents reported using DBT, with 89% of these using DBT clinically. Participants were more likely to report DBT use if they worked at an academic practice (odds ratio [OR], 2.07; 95% confidence interval [CI], 1.41 to 3.03; P < .001), a practice with more than 3 breast imagers (OR, 2.36; 95% CI, 1.62 to 3.43; P < .001), or a practice with 7 or more mammography units (OR, 3.05; 95% CI, 2.11 to 4.39; P < .001). Criteria used to select patients to undergo DBT varied, with 107 (68.2%) using exam type (screening versus diagnostic), 25 (15.9%) using mammographic density, and 25 (15.9%) using breast cancer risk. Fees for DBT ranged from $25 to $250. In addition, 62.3% of nonusers planned to obtain DBT.

Conclusion: DBT is becoming more common but remains a limited resource. Clinical guidelines would assist practices in deciding whether to adopt DBT and in standardizing which patients should receive DBT.

Keywords: Digital breast tomosynthesis; breast cancer; mammography.

MeSH terms

  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / epidemiology
  • Fees and Charges / statistics & numerical data
  • Female
  • Health Care Surveys
  • Humans
  • Mammography / economics*
  • Mammography / statistics & numerical data*
  • Practice Patterns, Physicians' / economics
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Radiographic Image Enhancement / economics*
  • Radiology / economics
  • Radiology / statistics & numerical data
  • United States / epidemiology
  • Utilization Review*