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European Radiology

, Volume 21, Issue 4, pp 676–682 | Cite as

The impact of digital mammography on screening a young cohort of women for breast cancer in an urban specialist breast unit

  • Nicholas M. PerryEmail author
  • N. Patani
  • S. E. Milner
  • K. Pinker
  • K. Mokbel
  • P. C. Allgood
  • S. W. Duffy
Breast

Abstract

Objective

To compare the diagnostic performance of full-field digital mammography (FFDM) with screen-film mammography (SFM) in a corporate screening programme including younger women.

Methods

Data were available on 14,946 screening episodes, 5010 FFDM and 9936 SFM. Formal analysis was by logistic regression, adjusting for age and calendar year. FFDM is compared with SFM with reference to cancer detection rates, cancers presenting as clustering microcalcifications, recall rates and PPV of recall.

Results

Overall detection rates were 6.4 cancers per thousand screens for FFDM and 2.8 per thousand for SFM (p < 0.001). In women aged 50+ cancer detection was significantly higher for FFDM at 8.6 per thousand vs. 4.0 per thousand, (p = 0.002). In women <50, cancer detection was also significantly higher for FFDM at 4.3 per thousand vs. 1.4 per thousand, (p = 0.02). Cancers detected as clustering microcalcifications increased from 0.4 per thousand with SFM to 2.0 per thousand with FFDM. Rates of assessment recall were higher for FFDM (7.3% vs. 5.0%, p < 0.001). FFDM provided a higher PPV for assessment recall, (32 cancers/364 recalls, 8.8%) than SFM, (28 cancers/493 recalls, 5.7%).

Conclusions

Cancer detection rates were significantly higher for FFDM than for SFM, especially for women <50, and cancers detected as clustering microcalcifications.

Keywords

FFDM SFM Screening Younger women Microcalcifications 

References

  1. 1.
    IARC Working Group on the Evaluation of Cancer Preventive Strategies (2002) Breast cancer screening. IARC handbooks of cancer prevention. IARC, LyonGoogle Scholar
  2. 2.
    Smith RA, Saslow D, Sawyer KA et al (2003) American Cancer Society guidelines for breast cancer screening: update 2003. CA Cancer J Clin 53:141–169PubMedCrossRefGoogle Scholar
  3. 3.
    Perry N, Broeders M, de Wolf C, Tornberg S, Holland R, von Karsa L (2008) European guidelines for quality assurance in breast cancer screening and diagnosis, 4th Edition. European Commission, XIV:3–416Google Scholar
  4. 4.
    Pisano ED, Gatsonis C, Hendrick E et al (2005) Diagnostic performance of digital versus film mammography for breast-cancer screening. N Engl J Med 353:1773–1783PubMedCrossRefGoogle Scholar
  5. 5.
    Pisano ED, Gatsonis CA, Yaffe MJ et al (2005) American College of Radiology Imaging Network digital mammographic imaging screening trial: objectives and methodology. Radiology 236:404–412PubMedCrossRefGoogle Scholar
  6. 6.
    Del Turco MR, Mantellini P, Ciatto S et al (2007) Full-field digital versus screen-film mammography: comparative accuracy in concurrent screening cohorts. AJR Am J Roentgenol 189:860–866PubMedCrossRefGoogle Scholar
  7. 7.
    Vigeland E, Klaasen H, Klingen TA, Hofvind S, Skaane P (2008) Full-field digital mammography compared to screen film mammography in the prevalent round of a population-based screening programme: the Vestfold County study. Eur Radiol 18:183–191PubMedCrossRefGoogle Scholar
  8. 8.
    Skaane P, Hofvind S, Skjennald A (2007) Randomized trial of screen-film versus full-field digital mammography with soft-copy reading in population-based screening program: follow-up and final results of Oslo II study. Radiology 244:708–717PubMedCrossRefGoogle Scholar
  9. 9.
    Forrest A (1986) Breast cancer screening: report to the health ministers of England, Wales, Scotland and Northern Ireland. HMSO1986Google Scholar
  10. 10.
    NHS Breast Screening Programme (2009) Annual review. NHS cancer screening programmes http://www.cancerscreening.nhs.uk/
  11. 11.
    FDA (2010) MQSAScorecard. Available via www.fda.gov/cdch/mammography/scorecard-statistics.html. Accessed 13 July 2010
  12. 12.
    Clayton R, Hills M (1993) Statistical models in epidemiology. Oxford University Press, OxfordGoogle Scholar
  13. 13.
    Vinnicombe S, Pinto Pereira SM, McCormack VA, Shiel S, Perry N, Dos Santos Silva IM (2009) Full-field digital versus screen-film mammography: comparison within the UK breast screening program and systematic review of published data. Radiology 251:347–358PubMedCrossRefGoogle Scholar
  14. 14.
    Bluekens AM, Karssemeijer N, Beijerinck D et al (2010) Consequences of digital mammography in population-based breast cancer screening: initial changes and long-term impact on referral rates. Eur Radiol 20:2067–2073PubMedCrossRefGoogle Scholar
  15. 15.
    Van Ongeval C, Bosmans H, Van Steen A (2005) Current challenges of full field digital mammography. Radiat Prot Dosim 117:148–153CrossRefGoogle Scholar
  16. 16.
    Pisano ED, Cole EB, Kistner EO et al (2002) Interpretation of digital mammograms: comparison of speed and accuracy of soft-copy versus printed-film display. Radiology 223:483–488PubMedCrossRefGoogle Scholar
  17. 17.
    Skaane P, Young K, Skjennald A (2003) Population-based mammography screening: comparison of screen-film and full-field digital mammography with soft-copy reading–Oslo I study. Radiology 229:877–884PubMedCrossRefGoogle Scholar
  18. 18.
    NHS Breast Screening Programme (2008) Annual review, NHS Cancer Screening ProgrammeGoogle Scholar
  19. 19.
    Gilbert FJ, Astley SM, Gillan MG et al (2008) Single reading with computer-aided detection for screening mammography. N Engl J Med 359:1675–1684PubMedCrossRefGoogle Scholar
  20. 20.
    Olivotto IA, Kan L, d’Yachkova Y et al (2000) Ten years of breast screening in the Screening Mammography Program of British Columbia, 1988–97. J Med Screen 7:152–159PubMedCrossRefGoogle Scholar
  21. 21.
    Perry NM, Allgood PC, Milner SE, Mokbel K, Duffy SW (2008) Mammographic breast density by area of residence: possible evidence of higher density in urban areas. Curr Med Res Opin 24:365–368PubMedCrossRefGoogle Scholar
  22. 22.
    Freer TW, Ulissey MJ (2001) Screening mammography with computer-aided detection: prospective study of 12, 860 patients in a community breast center. Radiology 220:781–786PubMedCrossRefGoogle Scholar
  23. 23.
    Skaane P (2009) Studies comparing screen-film mammography and full-field digital mammography in breast cancer screening: updated review. Acta Radiol 50:3–14PubMedCrossRefGoogle Scholar
  24. 24.
    Lewin JM, D’Orsi CJ, Hendrick RE et al (2002) Clinical comparison of full-field digital mammography and screen-film mammography for detection of breast cancer. AJR Am J Roentgenol 179:671–677PubMedGoogle Scholar
  25. 25.
    Skaane P, Skjennald A, Young K et al (2005) Follow-up and final results of the Oslo I Study comparing screen-film mammography and full-field digital mammography with soft-copy reading. Acta Radiol 46:679–689PubMedCrossRefGoogle Scholar
  26. 26.
    Kopans DB (2005) Digital breast tomosynthesis and other applications of digital mammography. In: Feig SA (ed) Categorical course in diagnostic radiology: breast imaging. Radiological Society of North America, Oak Brook, pp 83–91Google Scholar
  27. 27.
    Rafferty EA (2007) Digital mammography: novel applications. Radiol Clin North Am 45:831–843, viiPubMedCrossRefGoogle Scholar
  28. 28.
    Yaffe MJ, Barnes GT, Orton CG (2006) Point/Counterpoint. Film mammography for breast cancer screening in younger women is no longer appropriate because of the demonstrated superiority of digital mammography for this age group. Med Phys 33:3979–3982PubMedCrossRefGoogle Scholar

Copyright information

© European Society of Radiology 2010

Authors and Affiliations

  • Nicholas M. Perry
    • 1
    Email author
  • N. Patani
    • 2
  • S. E. Milner
    • 1
  • K. Pinker
    • 3
  • K. Mokbel
    • 1
  • P. C. Allgood
    • 4
  • S. W. Duffy
    • 4
  1. 1.The London Breast InstituteThe Princess Grace HospitalLondonUK
  2. 2.Department of Breast SurgerySt. George’s University of LondonLondonUK
  3. 3.Department of Radiology, Division of Molecular and Gender ImagingMedical University ViennaViennaAustria
  4. 4.Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and DentistryQueen Mary University of LondonLondonUK

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