Differences in radiological patterns, tumour characteristics and diagnostic precision between digital mammography and screen-film mammography in four breast cancer screening programmes in Spain
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To compare tumour characteristics between cancers detected with screen-film mammography (SFM) and digital mammography (DM) and to evaluate changes in positive predictive values (PPVs) for further assessments, for invasive procedures and for distinct radiological patterns in recalled women.
242,838 screening mammograms (171,191 SFM and 71,647 DM) from 103,613 women aged 45–69 years, performed in four population-based breast cancer screening programmes in Spain, were included. The tumour characteristics and PPVs of each group were compared. Radiological patterns (masses, calcifications, distortions and asymmetries) among recalled women were described and PPVs were evaluated.
The percentages of ductal carcinoma in situ (DCIS) were higher in DM than in SFM both in the first [18.5% vs. 15.8%(p = 0.580)] and in successive screenings [23.2% vs. 15.7%(p = 0.115)]. PPVs for masses, asymmetries and calcifications were higher in DM, being statistically significant in masses (5.3% vs. 3.9%; proportion ratio: 1.37 95%CI: 1.08–1.72). Among cancers detected by calcifications, the percentage of DCIS was higher in DM (60.3% vs. 46.4%, p = 0.060).
PPVs were higher when DM was used, both for further assessments and for invasive procedures, with similar cancer detection rates and no statistically significant differences in tumour characteristics. The greatest improvements in PPVs were found for masses.
- Differences in radiological patterns, tumour characteristics and diagnostic precision between digital mammography and screen-film mammography in four breast cancer screening programmes in Spain
Volume 21, Issue 9 , pp 2020-2028
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- Print ISSN
- Online ISSN
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- Digital mammography
- Screen-film mammography
- Breast cancer
- Breast imaging
- Ductal carcinoma in situ
- Industry Sectors
- Author Affiliations
- 1. Department of Epidemiology and Evaluation, IMIM-Hospital del Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain
- 2. CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- 3. EHEA Doctoral Program in Public Health. Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Universitat Autònoma de Barcelona (UAB), Bellaterra, Barcelona, Spain
- 4. General Directorate of Public Health. Department of Health, Government of Cantabria, C/ Federico Vial, 13, 39009, Santander, Spain
- 5. Radiology Unit. Hospital Santa Caterina, C/ Doctor Castany s/n, 17190, Girona, Spain
- 6. General Directorate Public Health & Centre for Public Health Research (CSISP), Avd. Catalunya, 21, 46002, Valencia, Spain
- 7. Radiology Unit, Hospital Universitario Marqués de Valdecilla, Avda. Valdecilla, 25, 39008, Santander, Spain
- 8. Radiology and Nuclear Medicine Service, Hospital del Mar, Passeig Marítim, 08003, Barcelona, Spain
- 9. Breast Cancer Screening Unit Burjassot.Valencia (Spain) & Centre for Public Health Research (CSISP), C/ Sixto Cámara, 12. 46100 Burjasot, Valencia, Spain