Differences in radiological patterns, tumour characteristics and diagnostic precision between digital mammography and screen-film mammography in four breast cancer screening programmes in Spain
- First Online:
- 214 Downloads
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.
KeywordsDigital mammography Screen-film mammography Screening Breast cancer Breast imaging Ductal carcinoma in situ
- 2.Vinnicombe S, Pinto Pereira SM, McCormack VA, Shiel S, Perry N, Dos Santos Silva IM (2005) Full-field digital versus screen-film mammography: comparison within the UK breast screening programme and systematic review of published data. Radiology 251:347–358. doi:10.1148/radiol.2512081235 CrossRefGoogle Scholar
- 5.Sala M, Comas M, Macia F, Martinez J, Casamitjana M, Castells X (2009) Implementation of digital mammography in a population-based breast cancer screening programme: effect of screening round on recall rate and cancer detection. Radiology 252:31–39. doi:10.1148/radiol.2521080696 PubMedCrossRefGoogle Scholar
- 9.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 programmeme: The Vestfold county study. Eur Radiol 18:183–191. doi:10.1007/s00330-007-0730-y PubMedCrossRefGoogle Scholar
- 13.Hambly NM, McNicholas MM, Phelan N, Hargaden GC, O’Doherty A, Flanagan FL (2009) Comparison of digital mammography and screen-film mammography in breast cancer screening: a review in the Irish breast screening programme. AJR Am J Roentgenol 193:1010–1018. doi:10.2214/AJR.08.2157 PubMedCrossRefGoogle Scholar
- 17.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 programme: follow-up and final results of Oslo II study. Radiology 244:708–717. doi:10.1148/radiol.2443061478 PubMedCrossRefGoogle Scholar
- 19.Román R, Sala M, Salas D, Ascunce N, Zubizarreta R, Castells X, et al. (2011) Effect of protocol-related variables and women’s characteristics on the cumulative false-positive risk in breast cancer screening. Ann Oncol doi:10.1093/annonc/mdr032
- 22.Allred DC (2010) Ductal carcinoma in situ: terminology, classification, and natural history. J Natl Cancer Inst Monogr 2010:134–138. doi:10.1093/jncimonographs/lgq035
- 24.Kerlikowske K (2010) Epidemiology of ductal carcinoma in situ. J Natl Cancer Inst Monogr 2010:139–141. doi:10.1093/jncimonographs/lgq027
- 26.Weigel S, Batzler WU, Decker T, Hense HW, Heindel W (2009) First epidemiological analysis of breast cancer incidence and tumour characteristics after implementation of population-based digital mammography screening. Rofo 181:1144–1150. doi:10.1055/s-0028-1109831,10.1055/s-0028-1109831 PubMedGoogle Scholar
- 27.Yang WT, Lai CJ, Whitman GJ, Murphy WA, Dryden MJ, Kushwaha AC, Sahin AA, Johnston D, Dempsey PJ, Shaw CC (2006) Comparison of full-field digital mammography and screen-film mammography for detection and characterization of simulated small masses. AJR Am J Roentgenol 187:W576–581. doi:10.2214/AJR.05.0126 PubMedCrossRefGoogle Scholar
- 28.Pinker K, Perry N, Vinnicombe S, Shiel S, Weber M (2011) Conspicuity of breast cancer according to histopathological type and breast density when imaged by full-field digital mammography compared with screen-film mammography. Eur Radiol 21(1):18–25. doi:10.1007/s00330-010-1906-4 PubMedCrossRefGoogle Scholar