The Screening Value of Mammography for Breast Cancer: An Overview of 22 Systematic Reviews with Evidence Mapping

Background: Several meta-analyses have evaluated the screening value of mammography for breast cancer, but the overall results have remained mixed or inconclusive. Methods: : Comprehensive literature search was conducted for SRs (systematic reviews) in Chinese Biomedical Databases (CBM), Cochrane Library, EMBASE, and PubMed until July 10, 2020. SRs with meta-analysis reported the benefit and performance of mammography screening were included. Two reviewers independently extracted data and performed the methodological quality assessments using The Risk Of Bias In Systematic Reviews (ROBIS). The characteristics of included SRs, the results of the quality of Risk of bias (RoBs) assessment and the pooled estimates of effect size were descriptively summarized using systematically structured tables and evidence mapping. Results: : Twenty two systematic reviews with meta-analysis were included. Only 13.6% of SRs were assessed as low-risk bias according to the overall risk of bias rating results in ROBIS tool. Pooled estimates for a reduction in breast cancer mortality attributable to mammography screening were range from 0.51 (OR, 95% CI: 0.46-0.55) to 1.04 (RR, 95% CI: 0.84-1.27). Sensitivity of difference mammography was ranged from 55% to 91%, specificity of difference mammography was ranged from 84% to 97%. According to the results of included SRs suggested, the statistically significant was observed that digital breast tomosynthesis (DBT) increased the cancer detected rate (CDR) and reduced the recall rate compared to digital mammography (DM), DM increased the CDR compared to screen-film mammography (SFM), and add DBT to digital or synthetic mammography increases the sensitivity, specificity, and CDR than DBT alone. Conclusions: : Further study should investigate the value of different imaging technology in breast cancer screening. Systematic review registration: PROSPERO CRD42020207227