Cone-beam breast computed tomography
Topic Status Complete
Cone-beam computed tomography for breast imaging in people with suspected breast cancer
Specialities: Cancer
Outcome of the appraisal
More evidence is needed on cone-beam computed tomography for breast imaging for individuals with suspected breast cancer.
There was limited clinical effectiveness evidence for cone-beam computed tomography (CBBCT) for breast imaging for individuals with suspected breast cancer.
HTW was unable to determine cost effectiveness because the effectiveness evidence was insufficient to use for a robust evaluation.
Why was this topic appraised?
Breast cancer is the most common type of cancer in the UK, with over 55,000 new cases diagnosed each year. Early detection, which reduces both breast cancer mortality and burden, is therefore essential.
Breast cancer may be suspected due to symptoms or signs but also because of an abnormal screening test. In Wales, individuals aged from 50 to 70 years, who are registered as female, are automatically invited for breast screening every three years. Suspected breast cancer is usually investigated with a triple assessment approach, including clinical examination, imaging (usually mammography and/or ultrasound), and biopsy. Other imaging methods may be used in selected cases, such as digital breast tomosynthesis (DBT), magnetic resonance imaging (MRI) scans, or contrast-enhanced mammography (CEM).
CBBCT is another breast imaging modality that can be used to create high-resolution, three-dimensional (3D) images of each breast in approximately seven seconds, using comparable radiation to that of conventional mammography and with less breast compression than mammography. It is claimed to provide more accurate results for dense breast tissue and to detect smaller lesions than two-dimensional (2D) mammography.
This topic was proposed by Euronoxx Medical Group (London, UK) which is the UK distributor of Koning Vera CT (Koning Corporation; Delaware, USA).
Plain language summary
What is breast cancer?
Breast cancer happens when cells in the breast grow in an abnormal way and form a lump (tumor). Breast cancer may be suspected because of symptoms or signs, or after an abnormal breast imaging result. Symptoms can include:
- A lump or thickened area in the breast
- Changes to the skin, such as dimpling, redness, or puckering
- Fluid or discharge from the nipple.
Treatment for breast cancer depends on the type and stage. It can include surgery, chemotherapy, radiotherapy, or hormone therapy.
How is breast cancer usually checked?
Doctors take X-ray images of breast tissue (mammograms) to look for changes. Each breast is X-rayed from above and the side. To do this, the breast is pressed between two panels (compression). This can feel uncomfortable, and for some people it is painful.
What is cone-beam breast CT (CBBCT)?
CBBCT is a newer type of breast scan that creates a 3D picture of each breast. It uses a cone-shaped X-ray beam to take a full 3D image in one go. It uses a similar level of radiation to a standard mammogram and involves less breast compression.
What did Health Technology Wales do?
HTW looked for evidence on the use of CBBCT in breast cancer diagnosis. More evidence is needed on CBBCT for breast imaging for individuals with suspected breast cancer.
Guidance
GUI075 04.2026
Evidence Appraisal Report
EAR075 04.2026
Topic Exploration Report
TER594 03.2025 (superseded by EAR075 04.2026)
Health Technology Wales Partners
