{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:13:21Z","timestamp":1790806401513,"version":"4.1.0"},"reference-count":49,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"13","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2023,5,1]]},"abstract":"<jats:sec><jats:title>PURPOSE<\/jats:title><jats:p> To assess diagnostic performance of digital breast tomosynthesis (DBT) alone or combined with technologist-performed handheld screening ultrasound (US) in women with dense breasts. <\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p> In an institutional review board\u2013approved, Health Insurance Portability and Accountability Act\u2013compliant multicenter protocol in western Pennsylvania, 6,179 women consented to three rounds of annual screening, interpreted by two radiologist observers, and had appropriate follow-up. Primary analysis was based on first observer results. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p> Mean participant age was 54.8 years (range, 40-75 years). Across 17,552 screens, there were 126 cancer events in 125 women (7.2\/1,000; 95% CI, 5.9 to 8.4). In year 1, DBT-alone cancer yield was 5.0\/1,000, and of DBT+US, 6.3\/1,000, difference 1.3\/1,000 (95% CI, 0.3 to 2.1; P = .005). In years 2 + 3, DBT cancer yield was 4.9\/1,000, and of DBT+US, 5.9\/1,000, difference 1.0\/1,000 (95% CI, 0.4 to 1.5; P &lt; .001). False-positive rate increased from 7.0% for DBT in year 1 to 11.5% for DBT+US and from 5.9% for DBT in year 2 + 3 to 9.7% for DBT+US ( P &lt; .001 for both). Nine cancers were seen only by double reading DBT and one by double reading US. Ten interval cancers (0.6\/1,000 [95% CI, 0.2 to 0.9]) were identified. Despite reduction in specificity, addition of US improved receiver operating characteristic curves, with area under receiver operating characteristic curve increasing from 0.83 for DBT alone to 0.92 for DBT+US in year 1 ( P = .01), with smaller improvements in subsequent years. Of 6,179 women, across all 3 years, 172\/6,179 (2.8%) unique women had a false-positive biopsy because of DBT as did another 230\/6,179 (3.7%) women because of US ( P &lt; .001). <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p> Overall added cancer detection rate of US screening after DBT was modest at 19\/17,552 (1.1\/1,000; CI, 0.5- to 1.6) screens but potentially overcomes substantial increases in false-positive recalls and benign biopsies. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.22.01445","type":"journal-article","created":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T20:59:45Z","timestamp":1673384385000},"page":"2403-2415","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":25,"title":["Prospective Multicenter Diagnostic Performance of Technologist-Performed Screening Breast Ultrasound After Tomosynthesis in Women With Dense Breasts (the DBTUST)"],"prefix":"10.1200","volume":"41","clinical-trial-number":[{"clinical-trial-number":"nct02643966","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8792-6185","authenticated-orcid":false,"given":"Wendie A.","family":"Berg","sequence":"first","affiliation":[{"name":"Department of Radiology, University of Pittsburgh School of Medicine, Magee-Womens Hospital of UPMC, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2127-8346","authenticated-orcid":false,"given":"Margarita L.","family":"Zuley","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Pittsburgh School of Medicine, Magee-Womens Hospital of UPMC, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas S.","family":"Chang","sequence":"additional","affiliation":[{"name":"Weinstein Imaging Associates, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terri-Ann","family":"Gizienski","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Pittsburgh School of Medicine, Magee-Womens Hospital of UPMC, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise M.","family":"Chough","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Pittsburgh School of Medicine, Magee-Womens Hospital of UPMC, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcela","family":"B\u00f6hm-V\u00e9lez","sequence":"additional","affiliation":[{"name":"Weinstein Imaging Associates, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle E.","family":"Sharek","sequence":"additional","affiliation":[{"name":"Weinstein Imaging Associates, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle R.","family":"Straka","sequence":"additional","affiliation":[{"name":"Weinstein Imaging Associates, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane M.","family":"Hakim","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Pittsburgh School of Medicine, Magee-Womens Hospital of UPMC, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie Y.","family":"Hartman","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Pittsburgh School of Medicine, Magee-Womens Hospital of UPMC, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly S.","family":"Harnist","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Pittsburgh School of Medicine, Magee-Womens Hospital of UPMC, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathy S.","family":"Tyma","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Pittsburgh School of Medicine, Magee-Womens Hospital of UPMC, Pittsburgh, PA"},{"name":"Department of Radiology, New York University Grossman School of Medicine, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy E.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Pittsburgh School of Medicine, Magee-Womens Hospital of UPMC, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8208-9456","authenticated-orcid":false,"given":"Uzma","family":"Waheed","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Pittsburgh School of Medicine, Magee-Womens Hospital of UPMC, Pittsburgh, PA"},{"name":"Department of Radiology, Stanford University School of Medicine, Stanford, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Golbahar","family":"Houshmand","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Pittsburgh School of Medicine, Magee-Womens Hospital of UPMC, Pittsburgh, PA"},{"name":"Northwestern University Feinberg School of Medicine, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bronwyn E.","family":"Nair","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Pittsburgh School of Medicine, Magee-Womens Hospital of UPMC, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilip D.","family":"Shinde","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Pittsburgh School of Medicine, Magee-Womens Hospital of UPMC, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy H.","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Pittsburgh School of Medicine, Magee-Womens Hospital of UPMC, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andriy I.","family":"Bandos","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Pittsburgh School of Public Health, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy M.","family":"Berg","sequence":"additional","affiliation":[{"name":"Department of Computational and Systems Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole B.","family":"Lettiere","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Pittsburgh School of Medicine, Magee-Womens Hospital of UPMC, Pittsburgh, PA"},{"name":"ICON-Amgen, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie A.","family":"Ganott","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Pittsburgh School of Medicine, Magee-Womens Hospital of UPMC, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"b1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dju255"},{"key":"b2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.16.16489"},{"key":"b3","doi-asserted-by":"publisher","DOI":"10.7326\/M14-1465"},{"key":"b4","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-016-4090-7"},{"key":"b5","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.30430"},{"key":"b6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa062790"},{"key":"b7","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6601548"},{"key":"b8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2010.12.002"},{"key":"b9","doi-asserted-by":"publisher","DOI":"10.1001\/jama.299.18.2151"},{"key":"b10","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.388"},{"key":"b11","doi-asserted-by":"publisher","DOI":"10.1093\/jbi\/wbz055"},{"key":"b13","volume-title":"Follow-up and Outcome Monitoring, ACR BI-RADS Atlas, Breast Imaging Reporting and Data System","author":"Sickles EA","year":"2013"},{"key":"b14","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-9868.2007.00593.x"},{"key":"b15","doi-asserted-by":"publisher","DOI":"10.2307\/2531595"},{"key":"b17","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.18.20748"},{"key":"b18","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.63.4147"},{"key":"b19","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2018.08.029"},{"key":"b20","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2021203134"},{"key":"b21","doi-asserted-by":"publisher","DOI":"10.7326\/M14-0692"},{"key":"b22","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djv367"},{"key":"b23","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.19.21872"},{"key":"b24","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-021-26023-2"},{"key":"b25","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-17-1175"},{"key":"b27","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.11792"},{"key":"b28","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2017171148"},{"key":"b29","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2020191751"},{"key":"b30","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2019.09.012"},{"key":"b31","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2019191337"},{"key":"b32","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2020202858"},{"key":"b33","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2021203936"},{"key":"b34","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.7672"},{"key":"b35","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.0572"},{"key":"b36","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1903986"},{"key":"b37","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2016161444"},{"key":"b38","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2021203633"},{"key":"b39","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2541090953"},{"key":"b40","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2018.04.002"},{"key":"b42","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2017.11.034"},{"key":"b43","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.08.1706"},{"key":"b44","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.23.0839"},{"key":"b45","doi-asserted-by":"publisher","DOI":"10.1097\/RLI.0b013e3181f3fcdf"},{"key":"b46","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.17.19355"},{"key":"b47","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2019182660"},{"key":"b48","doi-asserted-by":"publisher","DOI":"10.3390\/cancers12123495"},{"key":"b49","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.20.23480"},{"key":"b50","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2018171472"},{"key":"b51","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-007-9528-5"},{"key":"b52","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-022-08617-6"},{"key":"b53","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2021.09.002"}],"container-title":["Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/JCO.22.01445","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T22:02:33Z","timestamp":1682546553000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/JCO.22.01445"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,1]]},"references-count":49,"journal-issue":{"issue":"13","published-print":{"date-parts":[[2023,5,1]]}},"alternative-id":["10.1200\/JCO.22.01445"],"URL":"https:\/\/doi.org\/10.1200\/jco.22.01445","relation":{},"ISSN":["0732-183X","1527-7755"],"issn-type":[{"value":"0732-183X","type":"print"},{"value":"1527-7755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,1]]},"assertion":[{"value":"2022-06-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-25","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-01-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}