Introduction
Digital breast tomosynthesis acquires multiple projection images to create pseudo three dimensional reconstructions that improve lesion conspicuity and reduce tissue overlap. Tomosynthesis enhances cancer detection and reduces recall rates compared with conventional mammography. Integration into screening programs requires protocol and workflow adjustments.
Clinical Evidence
Studies show tomosynthesis increases detection of invasive cancers and decreases false positives in screening populations. Supplemental imaging such as ultrasound or MRI may be indicated for dense breasts or high risk patients. Screening intervals and population selection should follow evidence based guidelines.
Technical and Workflow
Tomosynthesis requires optimized acquisition parameters and reconstruction algorithms to balance dose and image quality. Radiology workflows adapt to increased image volumes with reading strategies and CAD or AI assistance. Quality control and accreditation ensure consistent performance.
Patient Communication
Clear communication about benefits limitations and potential for additional imaging reduces anxiety and supports informed consent. Shared decision making addresses screening choices for individuals with dense breasts or elevated risk. Program metrics track detection rates recall rates and interval cancers.