Should tomosynthesis replace mammography for breast cancer screening?

A decade has passed since the first prospective trials showed that the mammography technology, digital breast tomosynthesis, increased the rate of cancer detection compared with digital mammography.1,2 A large body of evidence, comprising prospective non-randomised studies and retrospective studies,3 has since accumulated; however, evidence from randomised controlled trials is scarce. In The Lancet Oncology, Walter Heindel and colleagues report the results of the TOmosynthesis plus SYnthesised MAmmography Study (TOSYMA),4 a multicentre trial embedded in the German population-wide mammography screening programme.