European Radiology

, Volume 21, Issue 9, pp 2020–2028

Differences in radiological patterns, tumour characteristics and diagnostic precision between digital mammography and screen-film mammography in four breast cancer screening programmes in Spain

  • Laia Domingo
  • Anabel Romero
  • Francesc Belvis
  • Mar Sánchez
  • Joana Ferrer
  • Dolores Salas
  • Josefa Ibáñez
  • Alfonso Vega
  • Francesc Ferrer
  • M. Soledad Laso
  • Francesc Macià
  • Xavier Castells
  • Maria Sala
Breast

Abstract

Objectives

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.

Methods

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.

Results

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).

Conclusions

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.

Keywords

Digital mammography Screen-film mammography Screening Breast cancer Breast imaging Ductal carcinoma in situ 

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Copyright information

© European Society of Radiology 2011

Authors and Affiliations

  • Laia Domingo
    • 1
    • 2
    • 3
  • Anabel Romero
    • 1
    • 2
  • Francesc Belvis
    • 1
    • 2
  • Mar Sánchez
    • 4
  • Joana Ferrer
    • 5
  • Dolores Salas
    • 6
  • Josefa Ibáñez
    • 6
  • Alfonso Vega
    • 7
  • Francesc Ferrer
    • 8
  • M. Soledad Laso
    • 9
  • Francesc Macià
    • 1
    • 2
  • Xavier Castells
    • 1
    • 2
  • Maria Sala
    • 1
    • 2
    • 3
  1. 1.Department of Epidemiology and EvaluationIMIM-Hospital del Mar, Passeig Marítim 25-29BarcelonaSpain
  2. 2.CIBER de Epidemiología y Salud Pública (CIBERESP)BarcelonaSpain
  3. 3.EHEA Doctoral Program in Public Health. Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public HealthUniversitat Autònoma de Barcelona (UAB)BarcelonaSpain
  4. 4.General Directorate of Public Health. Department of HealthGovernment of CantabriaSantanderSpain
  5. 5.Radiology Unit. Hospital Santa CaterinaGironaSpain
  6. 6.General Directorate Public Health & Centre for Public Health Research (CSISP)ValenciaSpain
  7. 7.Radiology UnitHospital Universitario Marqués de ValdecillaSantanderSpain
  8. 8.Radiology and Nuclear Medicine ServiceHospital del MarBarcelonaSpain
  9. 9.Breast Cancer Screening Unit Burjassot.Valencia (Spain) & Centre for Public Health Research (CSISP)ValenciaSpain

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