Objective:

To evaluate false-positive recalls, including radiographic appearances and false-positive biopsies, in the Malm Breast Tomosynthesis Screening Trial (MBTST) to understand their implications for breast cancer screening.

Key Findings:

• The false-positive recall rate was higher for DBT alone compared to DM alone, primarily due to more recalls of stellate distortions, which may affect patient management.
• Over time, the false-positive recall rate decreased, indicating a learning curve that could improve screening outcomes.
• The majority of false-positive recalls were due to asymmetries and calcifications, highlighting areas for radiologist training.

Interpretation:

The findings suggest that while DBT may initially have a higher false-positive recall rate, this may improve with experience over time, potentially leading to better patient outcomes.

Limitations:

• The study was limited to a specific population in Malm, Sweden, which may affect generalizability and applicability to other regions.
• The analysis did not include long-term follow-up beyond the initial screening period, which could provide insights into the persistence of false-positive rates.

Conclusion:

The MBTST provides important insights into false-positive recalls in breast cancer screening with DBT, highlighting the need for ongoing evaluation as clinical experience grows to optimize screening protocols.