Breast Cancer, Tumors, Breast
Conditions
Brief summary
The aim of this recruitment plan (ADAPT-BX) is to collect image and technical data on both digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM), along with other subject data including histology results from biopsy specimen examination and cancer classification data from initially asymptomatic women referred for biopsy after recall from screening and diagnostic work-up. These data will be included in a subsequent and prospectively planned pooled analysis described in a separate protocol (ADAPT-BIE) examining superiority of DBT to FFDM for breast cancer diagnosis and other clinical performance measures.
Detailed description
ADAPT program consists of 2 recruitment plans (ADAPT-SCR and ADAPT-BX) followed by an off-line read of the images and data collected (ADAPT-BIE). This study involves the comparison of two devices that can identify abnormalities in routine breast screening and diagnostic mammography. Mammography is usually done with full-field digital mammography (FFDM), which takes flat, two-dimensional X-ray images of the breast. Doctors use the two-dimensional images to look for cancers and other abnormal tissue. The purpose of this study is to learn more about the accuracy of full-field digital mammography devices and a new mammography device called digital breast tomosynthesis (DBT). DBT is similar to full-field digital mammography, but can also move around the breast to get X-ray images from different angles, which provides a three-dimensional view that doctors can use to look for cancers and abnormal tissue. Subjects will be recruited from an initially asymptomatic population that have been referred for clinically indicated breast biopsy based on suspicious breast imaging results. Subjects will undergo a DBT mammogram prior to biopsy. If FFDM was not performed within 30 days, subjects will also undergo FFDM prior to biopsy. Results of biopsy(ies) and histopathology, including lesion characteristics, will be recorded and considered as truth if positive for cancer status. Subjects with negative or benign histological findings will be followed for approximately one year (10-16 months) by FFDM and any additional standard of care practice.
Interventions
Subjects underwent breast imaging using each device: DBT and FFDM.
Sponsors
Study design
Intervention model description
All participants underwent 2D breast imaging with Full-field digital mammography (FFDM) and by 3D breast imaging with Digital Breast Tomosynthesis (DBT).
Eligibility
Inclusion criteria
* Women aged 30 years or older (≥30 years old); * Initially asymptomatic women that underwent routine screening FFDM, breast ultrasound (U/S), breast magnetic resonance imaging (MRI) and/or DBT, followed by diagnostic work-up showing one of more abnormalities and referred for breast biopsy within of 30 days before study entry; * Are able and willing to comply with study procedures; * Have signed and dated the informed consent form; * Documented as non-pregnant based on the investigator's medical judgment and in consideration of local clinical practice standards for evidence of non-pregnancy.
Exclusion criteria
* Have been previously included in this study; * Have undergone diagnostic or surgical intervention(s) or procedure(s) on either breast, including mastectomy and cytopunction, before study-related imaging; * Have breasts too large to be adequately positioned on 24 x 31 centimeter (cm) FFDM digital receptor without anatomical cut off during a DBT examination (or FFDM, if required); * Have participated in (within the prior 30 days), another trial of an investigational product expected to interfere with study procedures or outcomes; * Have breast implant(s); * Have reconstructed breast(s).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With DBT, FFDM and Biopsy Specimens Collected. | Approximately 8 weeks | For each participant, obtain image data using two methods (DBT and FFDM) and obtain histology results of biopsy specimens from women referred for biopsy. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Lesion Type Observed by FFDM Imaging | Approximately 8 weeks | Lesions were characterized based on findings identified during image evaluations performed by qualified readers. |
| Lesion Type Observed by DBT Imaging | Approximately 8 weeks | Lesions were characterized based on findings identified during image evaluations performed by qualified researchers. |
| Maximum Lesion Dimension as Observed by DBT | Approximately 8 weeks | Maximum length of lesions (measured in mm) when images were collected using DBT |
| Biopsy Finding of Lesions Per Subject. | Approximately 8 weeks | Describes histologic cancer and non-cancer findings of lesion biopsy. Cancer status of lesions was reported per subject, not per lesion. |
| Maximum Lesion Dimension as Observed by FFDM | Approximately 8 weeks | Maximum Length of Lesions (measured in mm) when images were collected using FFDM. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Safety - Device Related Malfunctions | less than 16 months | Number of device-related malfunctions by imaging modality. |
Countries
France, United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| DBT and FFDM Subjects underwent 2D breast imaging with full-field digital mammography (FFDM) followed by 3D breast imaging with digital breast tomosynthesis (DBT). Digital Breast Tomosynthesis: 3D imaging of the breast using Digital Breast Tomosynthesis (DBT) device. Full-Field Digital Mammography: 2D imaging of the breast using Full-Field Digital Mammography (FFDM) device.
DBT and FFDM: Subjects underwent breast imaging using each device: DBT and FFDM. | 196 |
| Total | 196 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Withdrawal by Subject | 37 |
Baseline characteristics
| Characteristic | DBT and FFDM | — |
|---|---|---|
| Age, Customized Age 30 years and greater | 196 Participants | — |
| Race and Ethnicity Not Collected | — | — Participants |
| Region of Enrollment France | 60 Participants | — |
| Region of Enrollment United States | 136 Participants | — |
| Sex: Female, Male Female | 196 Participants | — |
| Sex: Female, Male Male | 0 Participants | — |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 196 |
| other Total, other adverse events | 0 / 196 |
| serious Total, serious adverse events | 0 / 196 |
Outcome results
Number of Participants With DBT, FFDM and Biopsy Specimens Collected.
For each participant, obtain image data using two methods (DBT and FFDM) and obtain histology results of biopsy specimens from women referred for biopsy.
Time frame: Approximately 8 weeks
Population: Initially asymptomatic adult women presenting for breast biopsy based on prior breast imaging.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| DBT and FFDM | Number of Participants With DBT, FFDM and Biopsy Specimens Collected. | Participants that completed DBT, FFDM and Biopsy | 159 Participants |
| DBT and FFDM | Number of Participants With DBT, FFDM and Biopsy Specimens Collected. | Participants that did not complete all three tests | 37 Participants |
Biopsy Finding of Lesions Per Subject.
Describes histologic cancer and non-cancer findings of lesion biopsy. Cancer status of lesions was reported per subject, not per lesion.
Time frame: Approximately 8 weeks
Population: All lesions with a biopsy finding: positive/malignant, negative/benign or non-conclusive. Biopsy findings were reported per subject, not per lesion.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| DBT and FFDM | Biopsy Finding of Lesions Per Subject. | Lesions identified as positive/malignant | 62 participants |
| DBT and FFDM | Biopsy Finding of Lesions Per Subject. | Lesions identified as negative/benign | 94 participants |
| DBT and FFDM | Biopsy Finding of Lesions Per Subject. | Biopsy was no-conclusive | 3 participants |
Lesion Type Observed by DBT Imaging
Lesions were characterized based on findings identified during image evaluations performed by qualified researchers.
Time frame: Approximately 8 weeks
Population: Participants with DBT breast images collected, and lesion characteristic described by qualified reader. Participants may have more than one lesion.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| DBT and FFDM | Lesion Type Observed by DBT Imaging | Lesion description = mass | 97 lesions |
| DBT and FFDM | Lesion Type Observed by DBT Imaging | Lesion description = calcification | 67 lesions |
| DBT and FFDM | Lesion Type Observed by DBT Imaging | Lesion description = all other | 28 lesions |
Lesion Type Observed by FFDM Imaging
Lesions were characterized based on findings identified during image evaluations performed by qualified readers.
Time frame: Approximately 8 weeks
Population: Participants with lesions evaluated by FFDM. A single participant may have more than one lesion.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| DBT and FFDM | Lesion Type Observed by FFDM Imaging | Lesion description = mass | 76 lesions |
| DBT and FFDM | Lesion Type Observed by FFDM Imaging | Lesion description = calcification | 67 lesions |
| DBT and FFDM | Lesion Type Observed by FFDM Imaging | Lesion description = all other | 30 lesions |
Maximum Lesion Dimension as Observed by DBT
Maximum length of lesions (measured in mm) when images were collected using DBT
Time frame: Approximately 8 weeks
Population: Lesions observed and measured when images were collected using DBT. Sixteen (16) of the total 192 observed lesions were not measured.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| DBT and FFDM | Maximum Lesion Dimension as Observed by DBT | 12.24 millimeters (mm) | Standard Deviation 9.09 |
Maximum Lesion Dimension as Observed by FFDM
Maximum Length of Lesions (measured in mm) when images were collected using FFDM.
Time frame: Approximately 8 weeks
Population: Lesions observed and measured when images were collected when using FFDM; Seven (7) of the total 173 observed lesions were not measured.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| DBT and FFDM | Maximum Lesion Dimension as Observed by FFDM | 12.45 millimeters (mm) | Standard Deviation 9.89 |
Safety - Device Related Malfunctions
Number of device-related malfunctions by imaging modality.
Time frame: less than 16 months
Population: Number of device malfunctions recorded for either DBT or FFDM imaging.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| DBT and FFDM | Safety - Device Related Malfunctions | 0 malfunction events reported |