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Screening outcome in women repeatedly recalled for the same mammographic abnormality before, during and after the transition from screen-film to full-field digital screening mammography

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Abstract

Objective

The aim of this study was to retrospectively determine screening outcome in women recalled twice for the same mammographic lesion before, during, and after transition from screen-film (SFM) to full-field digital screening mammography (FFDM).

Methods

We included women with a repeated recall for the same mammographic abnormality (37 at subsequent SFM-screening, obtained between January 2000-April 2010; respectively 54 and 65 women with a prior SFM-screen or FFDM-screen followed by subsequent FFDM-screening, obtained between May 2009-July 2013).

Results

At SFM-screening, repeated recalls for the same lesion comprised 1.2 % of recalls (37/3217), including 13 malignancies (positive predictive value (PPV), 35.1 %). During the SFM to FFDM transition (SFM-screen followed by FFDM-screen), FFDM recalls comprised more repeated recalls for the same lesion (2.2 %, P = 0.002), with a lower PPV (14.8 %, P = 0.02). This proportion increased to 2.8 % after transition to FFDM (i.e., two successive FFDM-screens), with 16 malignancies (PPV, 24.6 %). Invasive cancers at repeated recall were smaller than interval cancers (T1a-c, 79.4 versus 46.8 %, P = 0.001), with less lymph node involvement (20.6 versus 46.5 %, P = 0.007).

Conclusions

More women are repeatedly recalled for the same mammographic abnormality during and after the transition from SFM to FFDM-screening, with comparable cancer risks before and after the transition. These cancers show better prognostic characteristics than interval cancers.

Key Points

• FFDM-screening increases the number of repeated recalls for the same mammographic abnormality.

• The PPV of these recalls is comparable before and after transition to FFDM-screening.

• Cancers diagnosed after a repeated recall are smaller than interval cancers.

• These cancers also show less lymph node involvement than interval cancers.

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Acknowledgments

The scientific guarantor of this publication is Lucien EM Duijm, M.D., Ph.D.. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. The Central Committee on Research Involving Human Subjects (CCMO) in The Hague, The Netherlands, waived ethical approval for this study. Women participating in our screening program are asked to give permission for the use of their data for quality assurance and scientific purposes. Four women screened at our units did not give this permission and they were excluded from analysis. No study subjects or cohorts have been previously reported. Methodology: prospective, observational, multicenter study / performed at one institution (one group of screening radiologists; assessment of recalled women at multiple institutions).

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Authors and Affiliations

  1. Department of Radiology, Catharina Hospital, PO Box 1530, 5602 ZA, Eindhoven, The Netherlands

    Rob van Bommel

  2. Department of Epidemiology, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands

    Adri C. Voogd

  3. Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), PO Box 19079, 3501 DB, Utrecht, The Netherlands

    Adri C. Voogd & Marieke W. Louwman

  4. Department of Surgery, Canisius-Wilhelmina Hospital, PO Box 9015, 6500 GS, Nijmegen, The Netherlands

    Luc J. Strobbe

  5. Department of Radiology, Canisius-Wilhelmina Hospital, Weg door Jonkerbos 100, PO Box 9015, 6500 GS, Nijmegen, The Netherlands

    Dick Venderink & Lucien E. M. Duijm

  6. Dutch Reference Centre for Screening, PO Box 6873, 6503GJ, Nijmegen, The Netherlands

    Lucien E. M. Duijm

Authors
  1. Rob van Bommel
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  2. Adri C. Voogd
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  3. Marieke W. Louwman
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  4. Luc J. Strobbe
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  5. Dick Venderink
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  6. Lucien E. M. Duijm
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Correspondence to Lucien E. M. Duijm.

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van Bommel, R., Voogd, A.C., Louwman, M.W. et al. Screening outcome in women repeatedly recalled for the same mammographic abnormality before, during and after the transition from screen-film to full-field digital screening mammography. Eur Radiol 27, 553–561 (2017). https://doi.org/10.1007/s00330-016-4399-y

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  • DOI: https://doi.org/10.1007/s00330-016-4399-y

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