Digital breast tomosynthesis in breast cancer screening: an ethical perspective

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</header> <main id="page-content"> <div class="page-section page-section-publications page-section-publications-view "> <section class="page-section-header page-section-header-publications page-section-header-publications-view no-backdrop-image" data-stickyheader="" style=""> <div class="container"> <div class="row"> <div class="introduction no-metrics"> <div class="rendering"><h1><span>Digital breast tomosynthesis in breast cancer screening: an ethical perspective</span></h1></div> <div class="rendering rendering_researchoutput rendering_researchoutput_associatespersonsclassifiedportal rendering_contributiontojournal rendering_associatespersonsclassifiedportal rendering_contributiontojournal_associatespersonsclassifiedportal"><p class="relations persons">Simon Rosenqvist, Johan Brännmark, <a rel="Person" href="https://portal.research.lu.se/en/persons/magnus-dustler" class="link person"><span>Magnus Dustler</span></a></div> <div class="rendering rendering_researchoutput rendering_researchoutput_associatesorganisationsportal rendering_contributiontojournal rendering_associatesorganisationsportal rendering_contributiontojournal_associatesorganisationsportal"><ul class="relations organisations"><li class="researchteam"><a rel="Organisation" href="https://portal.research.lu.se/en/organisations/medical-radiation-physics-malm%C3%A3" class="link"><span>Medical Radiation Physics, Malmö</span></a></li><li class="researchteam"><a rel="Organisation" href="https://portal.research.lu.se/en/organisations/radiology-diagnostics-malm%C3%A3" class="link"><span>Radiology Diagnostics, Malmö</span></a></li><li class="division"><a rel="Organisation" href="https://portal.research.lu.se/en/organisations/lucc-lund-university-cancer-centre" class="link"><span>LUCC: Lund University Cancer Centre</span></a></li></ul></div> <div class="rendering rendering_researchoutput rendering_researchoutput_associatesexternalorganisationsportal rendering_contributiontojournal rendering_associatesexternalorganisationsportal rendering_contributiontojournal_associatesexternalorganisationsportal"><ul class="relations organisations"><li><a rel="UEOExternalOrganisation" href="#" class="link"><span>University of Gothenburg</span></a></li><li><a rel="UEOExternalOrganisation" href="#" class="link"><span>Stockholm University</span></a></li></ul></div> <div class="rendering rendering_researchoutput rendering_researchoutput_publicationcontenttyperendererportalng rendering_contributiontojournal rendering_publicationcontenttyperendererportalng rendering_contributiontojournal_publicationcontenttyperendererportalng"><p class="type"><span class="type_family">Research output<span class="type_family_sep">: </span></span><span class="type_classification_parent">Contribution to journal<span class="type_parent_sep"> › </span></span><span class="type_classification">Debate/Note/Editorial</span><span class="type_classification"><span class="type_parent_sep"> › </span>peer-review</span></p></div> </div> <div class="publication-metrics" aria-label="Publication metrics section"> <div class="metrics-container"> <div class="metrics-wrap metrics-bottom "> <div class="metric metric-plum-x"> <a href="https://plu.mx/plum/a/?doi=10.1186/s13244-024-01790-w" class="plumx-plum-print-popup" data-on-empty="plumXError" data-on-fail="plumXError" data-on-success="plumXSuccess" data-popup="left" data-hide-when-empty="true" data-site="plum" data-badge="false"></a> </div> <div class="metric metric-altmetric"> <div data-badge-popover="top" data-badge-type="donut" data-doi="10.1186/s13244-024-01790-w" data-hide-no-mentions="true" data-link-target='_blank' class="altmetric-embed"></div> </div> </div> </div> </div> </div> </div> <div class="subMenu"> <div class="content-profile-navigation"> <div class="container"> <nav role="navigation"> <ul class="has-overflow-navigation" role="menubar"> <li class="selected" role="none"> <a class="portal_link" role="menuitem" href="/en/publications/digital-breast-tomosynthesis-in-breast-cancer-screening-an-ethica"><span> <i class="icon icon-publication" aria-hidden="true"></i> <span class="label">Overview</span> </span></a> </li> </ul> </nav> </div> </div> </div> </section> <div id="main-content" class="page-section-content page-section-content-publications page-section-content-publications-view no-margin "> <section class="page-section content-relation-section"> <div class="container"> <div class="clearfix"> <div class="content-content publication-content"> <h2 class="subheader">Abstract</h2> <div class="rendering rendering_researchoutput rendering_researchoutput_abstractportal rendering_contributiontojournal rendering_abstractportal rendering_contributiontojournal_abstractportal"><div class="textblock"><p>Abstract: Although digital breast tomosynthesis has higher sensitivity than digital mammography and at least as high specificity, digital mammography remains the most common method for conducting mammographic screening. At the same time, mammography systems are now delivered “DBT-ready” and can be used for either digital mammography or digital breast tomosynthesis. In this paper, we ask whether it is ethically permissible to use such equipment for digital mammography, given its lower sensitivity. We argue it is not, and that clinics are ethically required to use their DBT-ready equipment to screen with digital breast tomosynthesis whenever this is practically possible. Our argument relies on a comparison between digital breast tomosynthesis and a hypothesized improvement in the image quality of digital mammography. Critical relevance statement: Women may lose out on the benefits of screening with digital breast tomosynthesis when DBT-ready equipment is used to screen with digital mammography; we argue that this practice is ethically problematic. Key Points: Digital breast tomosynthesis finds more cases of breast cancer than digital mammography. Mammography equipment can often be used to screen with both digital breast tomosynthesis and digital mammography. When they can, clinics are ethically required to use existing equipment to screen with digital breast tomosynthesis instead of digital mammography.</p></div></div> <div class="rendering rendering_researchoutput rendering_researchoutput_detailsportal rendering_contributiontojournal rendering_detailsportal rendering_contributiontojournal_detailsportal"><div class="comment"><table class="properties"><tbody><tr class="language"><th scope="row">Original language</th><td>English</td></tr><tr><th scope="row">Article number</th><td>213</td></tr><tr><th scope="row">Journal</th><td><a rel="Journal" href="#" class="link"><span>Insights into Imaging</span></a></td></tr><tr><th scope="row">Volume</th><td>15</td></tr><tr><th scope="row">Issue number</th><td>1</td></tr><tr class="digital_object_identifiers"><th scope="row">DOIs</th><td><ul class="relations digital_object_identifiers"><li><a onclick="window.open(this.href, '_blank','noopener,noreferrer'); return false;" href="https://doi.org/10.1186/s13244-024-01790-w" class="link"><span>https://doi.org/10.1186/s13244-024-01790-w</span></a> </li></ul></td></tr><tr class="status"><th scope="row">Publication status</th><td><span class="prefix">Published - </span><span class="date">2024 Dec</span></td></tr></tbody></table></div></div> <div class="rendering rendering_keywordable rendering_expertkeywordgrouspbytypeportal rendering_keywordable_expertkeywordgrouspbytypeportal"><div class="keyword-group"><h2 class="subheader">Subject classification (UKÄ)</h2><ul class="relations keywords"><li><span>Radiology, Nuclear Medicine and Medical Imaging</span></li></ul></div><div class="keyword-group"><h2 class="subheader">Free keywords</h2><ul class="relations keywords"><li class="userdefined-keyword"><span>Breast</span></li><li class="userdefined-keyword"><span>Digital breast tomosynthesis</span></li><li class="userdefined-keyword"><span>Digital mammography</span></li><li class="userdefined-keyword"><span>Ethics</span></li><li class="userdefined-keyword"><span>Health policy</span></li></ul></div></div> </div> <div class="content-sidebar publication-sidebar"> <div class="sdg-content-wrap publication"> <h2 class="subheader">UN SDGs</h2> <p class="sdg-text">This output contributes to the following UN <a href="https://www.un.org/sustainabledevelopment/sustainable-development-goals/" target="_blank">Sustainable Development Goals (SDGs)</a></p> <ul class="sdgs-content"> <li> <img alt="SDG 3 - Good Health and Well-being" title="SDG 3 - Good Health and Well-being" class="good_health_and_well_being" src="/assets/sdg_icons/good_health_and_well_being-ca66cb937719976ce918816020def2ec.svg"/> </li> </ul> </div> <h2 class="subheader">Access to Document</h2> <div class="rendering rendering_researchoutput rendering_researchoutput_publicationaccessrenderer rendering_contributiontojournal rendering_publicationaccessrenderer rendering_contributiontojournal_publicationaccessrenderer"><ul class="dois"><li class="open-access"><div class="doi"><a onclick="window.open(this.href, '_blank','noopener,noreferrer'); return false;" href="https://doi.org/10.1186/s13244-024-01790-w" class="link"><span>10.1186/s13244-024-01790-w</span></a></div></li></ul></div> </div> </div> </div> </section> <section class="page-section cite"> <div class="container"> <section class="publication-cite" aria-labelledby="publications-cite-title"> <h2 class="subheader" id="publications-cite-title">Cite this</h2> <ul class="tabs has-overflow-navigation" role="tablist" aria-label="Cite this"> <li class="selected" role="tab" id="tab-0" aria-controls="cite-apa" tabindex="-1" aria-selected="false" > APA </li> <li class="" role="tab" id="tab-1" aria-controls="cite-author" tabindex="-1" aria-selected="false" > Author </li> <li class="" role="tab" id="tab-2" aria-controls="cite-BIBTEX" tabindex="-1" aria-selected="false" > BIBTEX </li> <li class="" role="tab" id="tab-3" aria-controls="cite-harvard" tabindex="-1" aria-selected="false" > Harvard </li> <li class="" role="tab" id="tab-4" aria-controls="cite-standard" tabindex="-1" aria-selected="false" > Standard </li> <li class="" role="tab" id="tab-5" aria-controls="cite-RIS" tabindex="-1" aria-selected="false" > RIS </li> <li class="" role="tab" id="tab-6" aria-controls="cite-vancouver" tabindex="-1" aria-selected="false" > Vancouver </li> </ul> <div class="tab-container"> <div id="cite-apa" class="tab selected" role="tabpanel" aria-labelledby="tab-0" tabindex="-1" aria-hidden="true"> <div class="rendering rendering_researchoutput rendering_researchoutput_apa rendering_contributiontojournal rendering_apa rendering_contributiontojournal_apa">Rosenqvist, S., Brännmark, J.<a rel="Person" href="https://portal.research.lu.se/en/persons/magnus-dustler" class="link"><span>, & Dustler, M.</span></a> (2024). <a rel="ContributionToJournal" href="https://portal.research.lu.se/en/publications/digital-breast-tomosynthesis-in-breast-cancer-screening-an-ethica" class="link"><span>Digital breast tomosynthesis in breast cancer screening: an ethical perspective</span></a>. <a rel="Journal" href="#" class="link"><span><em>Insights into Imaging</em></span></a>, <em>15</em>(1), Article 213. <a onclick="window.open(this.href, '_blank','noopener,noreferrer'); return false;" href="https://doi.org/10.1186/s13244-024-01790-w" class="link"><span>https://doi.org/10.1186/s13244-024-01790-w</span></a></div> </div> <div id="cite-author" class="tab " role="tabpanel" aria-labelledby="tab-1" tabindex="-1" aria-hidden="true"> <div class="rendering rendering_researchoutput rendering_researchoutput_author rendering_contributiontojournal rendering_author rendering_contributiontojournal_author">Rosenqvist, Simon ; Brännmark, Johan <a rel="Person" href="https://portal.research.lu.se/en/persons/magnus-dustler" class="link"><span> ; Dustler, Magnus</span></a>. / <a rel="ContributionToJournal" href="https://portal.research.lu.se/en/publications/digital-breast-tomosynthesis-in-breast-cancer-screening-an-ethica" class="link"><span><strong>Digital breast tomosynthesis in breast cancer screening : an ethical perspective</strong></span></a>. In: <a rel="Journal" href="#" class="link"><span>Insights into Imaging</span></a>. 2024 ; Vol. 15, No. 1.</div> </div> <div id="cite-BIBTEX" class="tab " role="tabpanel" aria-labelledby="tab-2" tabindex="-1" aria-hidden="true"> <div class="rendering rendering_researchoutput rendering_researchoutput_bibtex rendering_contributiontojournal rendering_bibtex rendering_contributiontojournal_bibtex"><div>@article{bfe673a9be9f4d6882c73113e082b34f,</div><div> title = "Digital breast tomosynthesis in breast cancer screening: an ethical perspective",</div><div> abstract = "Abstract: Although digital breast tomosynthesis has higher sensitivity than digital mammography and at least as high specificity, digital mammography remains the most common method for conducting mammographic screening. At the same time, mammography systems are now delivered “DBT-ready” and can be used for either digital mammography or digital breast tomosynthesis. In this paper, we ask whether it is ethically permissible to use such equipment for digital mammography, given its lower sensitivity. We argue it is not, and that clinics are ethically required to use their DBT-ready equipment to screen with digital breast tomosynthesis whenever this is practically possible. Our argument relies on a comparison between digital breast tomosynthesis and a hypothesized improvement in the image quality of digital mammography. Critical relevance statement: Women may lose out on the benefits of screening with digital breast tomosynthesis when DBT-ready equipment is used to screen with digital mammography; we argue that this practice is ethically problematic. Key Points: Digital breast tomosynthesis finds more cases of breast cancer than digital mammography. Mammography equipment can often be used to screen with both digital breast tomosynthesis and digital mammography. When they can, clinics are ethically required to use existing equipment to screen with digital breast tomosynthesis instead of digital mammography.",</div><div> keywords = "Breast, Digital breast tomosynthesis, Digital mammography, Ethics, Health policy",</div><div> author = "Simon Rosenqvist and Johan Br{\"a}nnmark and Magnus Dustler",</div><div> year = "2024",</div><div> month = dec,</div><div> doi = "10.1186/s13244-024-01790-w",</div><div> language = "English",</div><div> volume = "15",</div><div> journal = "Insights into Imaging",</div><div> issn = "1869-4101",</div><div> publisher = "Springer",</div><div> number = "1",</div><p>}</p></div> </div> <div id="cite-harvard" class="tab " role="tabpanel" aria-labelledby="tab-3" tabindex="-1" aria-hidden="true"> <div class="rendering rendering_researchoutput rendering_researchoutput_harvard rendering_contributiontojournal rendering_harvard rendering_contributiontojournal_harvard">Rosenqvist, S, Brännmark, J<a rel="Person" href="https://portal.research.lu.se/en/persons/magnus-dustler" class="link"><span> & Dustler, M</span></a> 2024, '<a rel="ContributionToJournal" href="https://portal.research.lu.se/en/publications/digital-breast-tomosynthesis-in-breast-cancer-screening-an-ethica" class="link harvard_title"><span>Digital breast tomosynthesis in breast cancer screening: an ethical perspective</span></a>', <a rel="Journal" href="#" class="link"><span><em>Insights into Imaging</em></span></a>, vol. 15, no. 1, 213. <a onclick="window.open(this.href, '_blank','noopener,noreferrer'); return false;" href="https://doi.org/10.1186/s13244-024-01790-w" class="link"><span>https://doi.org/10.1186/s13244-024-01790-w</span></a></div> </div> <div id="cite-standard" class="tab " role="tabpanel" aria-labelledby="tab-4" tabindex="-1" aria-hidden="true"> <div class="rendering rendering_researchoutput rendering_researchoutput_standard rendering_contributiontojournal rendering_standard rendering_contributiontojournal_standard"><a rel="ContributionToJournal" href="https://portal.research.lu.se/en/publications/digital-breast-tomosynthesis-in-breast-cancer-screening-an-ethica" class="link"><span><strong>Digital breast tomosynthesis in breast cancer screening: an ethical perspective.</strong></span></a> / Rosenqvist, Simon; Brännmark, Johan<a rel="Person" href="https://portal.research.lu.se/en/persons/magnus-dustler" class="link"><span>; Dustler, Magnus</span></a>. <br />In: <a rel="Journal" href="#" class="link"><span>Insights into Imaging</span></a>, Vol. 15, No. 1, 213, 12.2024.<p class="type"><span class="type_family">Research output<span class="type_family_sep">: </span></span><span class="type_classification_parent">Contribution to journal<span class="type_parent_sep"> › </span></span><span class="type_classification">Debate/Note/Editorial</span><span class="type_classification"><span class="type_parent_sep"> › </span>peer-review</span></p></div> </div> <div id="cite-RIS" class="tab " role="tabpanel" aria-labelledby="tab-5" tabindex="-1" aria-hidden="true"> <div class="rendering rendering_researchoutput rendering_researchoutput_ris rendering_contributiontojournal rendering_ris rendering_contributiontojournal_ris"><p>TY - JOUR</p><p>T1 - Digital breast tomosynthesis in breast cancer screening</p><p>T2 - an ethical perspective</p><p>AU - Rosenqvist, Simon</p><p>AU - Brännmark, Johan</p><p>AU - Dustler, Magnus</p><p>PY - 2024/12</p><p>Y1 - 2024/12</p><p>N2 - Abstract: Although digital breast tomosynthesis has higher sensitivity than digital mammography and at least as high specificity, digital mammography remains the most common method for conducting mammographic screening. At the same time, mammography systems are now delivered “DBT-ready” and can be used for either digital mammography or digital breast tomosynthesis. In this paper, we ask whether it is ethically permissible to use such equipment for digital mammography, given its lower sensitivity. We argue it is not, and that clinics are ethically required to use their DBT-ready equipment to screen with digital breast tomosynthesis whenever this is practically possible. Our argument relies on a comparison between digital breast tomosynthesis and a hypothesized improvement in the image quality of digital mammography. Critical relevance statement: Women may lose out on the benefits of screening with digital breast tomosynthesis when DBT-ready equipment is used to screen with digital mammography; we argue that this practice is ethically problematic. Key Points: Digital breast tomosynthesis finds more cases of breast cancer than digital mammography. Mammography equipment can often be used to screen with both digital breast tomosynthesis and digital mammography. When they can, clinics are ethically required to use existing equipment to screen with digital breast tomosynthesis instead of digital mammography.</p><p>AB - Abstract: Although digital breast tomosynthesis has higher sensitivity than digital mammography and at least as high specificity, digital mammography remains the most common method for conducting mammographic screening. At the same time, mammography systems are now delivered “DBT-ready” and can be used for either digital mammography or digital breast tomosynthesis. In this paper, we ask whether it is ethically permissible to use such equipment for digital mammography, given its lower sensitivity. We argue it is not, and that clinics are ethically required to use their DBT-ready equipment to screen with digital breast tomosynthesis whenever this is practically possible. Our argument relies on a comparison between digital breast tomosynthesis and a hypothesized improvement in the image quality of digital mammography. Critical relevance statement: Women may lose out on the benefits of screening with digital breast tomosynthesis when DBT-ready equipment is used to screen with digital mammography; we argue that this practice is ethically problematic. Key Points: Digital breast tomosynthesis finds more cases of breast cancer than digital mammography. Mammography equipment can often be used to screen with both digital breast tomosynthesis and digital mammography. When they can, clinics are ethically required to use existing equipment to screen with digital breast tomosynthesis instead of digital mammography.</p><p>KW - Breast</p><p>KW - Digital breast tomosynthesis</p><p>KW - Digital mammography</p><p>KW - Ethics</p><p>KW - Health policy</p><p>U2 - 10.1186/s13244-024-01790-w</p><p>DO - 10.1186/s13244-024-01790-w</p><p>M3 - Debate/Note/Editorial</p><p>C2 - 39186168</p><p>AN - SCOPUS:85202027537</p><p>SN - 1869-4101</p><p>VL - 15</p><p>JO - Insights into Imaging</p><p>JF - Insights into Imaging</p><p>IS - 1</p><p>M1 - 213</p><p>ER - </p></div> </div> <div id="cite-vancouver" class="tab " role="tabpanel" aria-labelledby="tab-6" tabindex="-1" aria-hidden="true"> <div class="rendering rendering_researchoutput rendering_researchoutput_vancouver rendering_contributiontojournal rendering_vancouver rendering_contributiontojournal_vancouver">Rosenqvist S, Brännmark J<a rel="Person" href="https://portal.research.lu.se/en/persons/magnus-dustler" class="link"><span>, Dustler M</span></a>. <span class="title"><a rel="ContributionToJournal" href="https://portal.research.lu.se/en/publications/digital-breast-tomosynthesis-in-breast-cancer-screening-an-ethica" class="link"><span>Digital breast tomosynthesis in breast cancer screening: <span class="subtitle">an ethical perspective</span></span></a></span>. <a rel="Journal" href="#" class="link"><span>Insights into Imaging</span></a>. 2024 Dec;15(1):213. doi: 10.1186/s13244-024-01790-w</div> </div> <script> $(function() { $(".tab-container .rendering a:not([href^='http://dx.doi.org'])").contents().unwrap(); 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