Comparison of Digital Mammography and Screen-Film Mammography in Breast Cancer Screening: A Review in the Irish Breast Screening Program

Hambly, Niamh; Mcnicholas, M. M. J.; Phelan, Niamh; Hargaden, Gormlaith; O’Doherty, Ann; Flanagan, Fidelma

doi:10.2214/ajr.08.2157

Cited by 110 publications

(81 citation statements)

References 20 publications

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“…Full-field Digital Mammography (FFDM) is the current standard imaging technique for the early detection of breast cancer [1][2][3] and high quality, artefact free, diagnostic images are crucial to the accuracy of this process. Unwanted motion during the image acquisition phase and subsequent image blurring is an unfortunate consequence in some FFDM images.…”

Section: Introductionmentioning

confidence: 99%

The impact of simulated motion blur on lesion detection performance in full-field digital mammography

Abdullah

Kelly

Thompson

et al. 2017

The British Journal of Radiology

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Objective: Motion blur is a known phenomenon in full-field digital mammography, but the impact on lesion detection is unknown. This is the first study to investigate detection performance with varying magnitudes of simulated motion blur.Method: Seven observers (15±5 years' reporting experience) evaluated 248 cases (62 containing malignant masses, 62 containing malignant microcalcifications and 124 normal cases) for three conditions: no blurring (0 mm) and two magnitudes of simulated blurring (0.7 mm and 1.5 mm).Abnormal cases were biopsy proven. Mathematical simulation was used to provide a pixel shift in order to simulate motion blur. A free-response observer study was conducted to compare lesion detection performance for the three conditions. The equally weighted jackknife alternative freeresponse receiver operating characteristic (wJAFROC) was used as the figure of merit. Test alpha was set at 0.05 to control probability of Type I error.Results: wJAFROC analysis found a statistically significant difference in lesion detection Advances in knowledge:This research demonstrates for the first time that motion blur has a negative and statistically significant impact on lesion detection performance digital mammography.

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Section: Introductionmentioning

confidence: 99%

The impact of simulated motion blur on lesion detection performance in full-field digital mammography

Abdullah

Kelly

Thompson

et al. 2017

The British Journal of Radiology

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“…Oslo 2 study [4] , showed significantly higher cancer detection rate with FFDM in women between 45 and 69 years of age (5.9 versus 3.8 per 1000 (p = 0.002). Studies [5,6,8,17] done in the context of routine screening mammograms showed similar results. Del Turco et al [5] and Vigeland et al [6] compared SFM and FFDM in a local population based programme and found statistically higher detection rate for FFDM, which was marked for cancers presenting with microcalcification.…”

Section: Discussionmentioning

confidence: 59%

“…In our study, we found significantly more cases presenting with distortion, 13(16.2%) in the SFM group versus 10 (10%) in the FFDM group. We have not found many studies so far which shows difference in detection rate of distortion between SFM and FFDM, apart from a study by Hambly et al [8] which showed higher detection rate of FFDM secondarily to improved detection of distortion and microcalcification. This discrepancy could be related to small numbers presenting with distortion.…”

Section: Discussionmentioning

confidence: 62%

“…This recall rate is well below the NHSBSP target of less than 7% for prevalent screening and 5% for incident screening examinations. Recall rate was higher for FFDM group in three [4,5,8] of the four studies showing higher detection for FFDM [4,5,8,16] . Skaane et al [4] had very low recall rate for SFM group, which might overestimate FFDM-SFM difference in detection rate.…”

Section: Discussionmentioning

confidence: 81%

“…There has been replacement of screen-film mammography (SFM) with full field digital mammography (FFDM) in many centres because of consistent image quality of digital images, ability to post-process digital images and improved storage and transmission capabilities [3] . A number of studies have been conducted to compare screen-film with digital mammography and results have shown that digital imaging is as good as SFM in population based screening practices [4][5][6][7][8] , although most of these studies rely on surrogate end points such as cancer detection rate, recall rate and tumour characteristics at diagnosis. Few studies have been done within an operational national screening programme [9][10][11][12] .…”

Section: Introductionmentioning

confidence: 99%

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Is full field digital mammography equivalent in performance to screen film mammography? UK perspective

Bansal

Lyburn

Jones

2014

IJDI

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Aim: The purpose of this project was to compare the performance of full-field digital imaging (FFDM) with screen film mammography (SFM). Methods:Data from 24,876 and 32,142 women in SFM and FFDM group respectively was collected retrospectively and comparison was made of the recall rate, breast cancer detection rate and positive predictive value (PPV) for the recalls for the two screening modalities, screen film mammography (SFM) and full field digital mammography (FFDM). Difference in radiologic characteristics of the tumours and tumour type (Ductal carcinoma in situ {DCIS} versus invasive) was also evaluated. Statistical software SPSS (PASW18) was used for data analysis with Pearson chi-square and Mann-Whitney-U test used to compare the two groups. A p value of less that 0.05 was considered to indicate a statistically significant difference. Results:In the year 2008-2009(SFM group), there was a recall rate of 4.5% and a cancer detection rate of 7.5/1000 in the recalled group. For the year 2009-2010 (FFDM group), there was a recall rate of 4.9% and cancer detection rate of 8.8/1000 in the recalled group. There was no statistically significant difference between the recall rate and cancer detection rate between the two groups (p = 0.157). Within the digital group, there was 88(88%) invasive cancer and 12(12%) non-invasive cancer, whereas within the analogue group, there were 74 (92.5%) invasive cancer and 6(7.5%) non-invasive cancer. Most of the non-invasive cancers in the FFDM group were high grade with only one mixed low-intermediate grade. In the analogue group, 50% were high grade, rest being low or intermediate grade. The histological distribution of cancer between two groups was not found to be statistically significant (p = 0.108). Conclusion:Our study demonstrated FFDM was similar to SFM in terms of cancer detection rate, recall rate and positive predictive value for recalls. KeywordsScreen-film mammography, Full-field digital mammography, Ductal carcinoma in situ, Breast neoplasms, Cancer screening

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Screening outcome and surgical treatment during and after the transition from screen‐film to digital screening mammography in the south of The Netherlands

Weber

Voogd

Strobbe

et al. 2014

Intl Journal of Cancer

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We determined screening outcome of subsequent screens during and after the transition from screen-film mammography (SFM) to full-field digital mammography (FFDM). A consecutive series of 102,863 subsequent (SFM screens with a prior SFM screen (SFM-SFM cohort), 91,941 FFDM screens with a prior SFM screen (FFDM-SFM cohort) and 90,407 FFDM screens with a prior FFDM screen (FFDM-FFDM cohort) were obtained between January 2006 and July 2013. The referral rate and cancer detection rate (CDR) per 1,000 screens were higher at FFDM-SFM than at SFM-SFM (2.7% vs. 1.2% (p < 0.001) and 7.0 vs. 4.9, p < 0.001), at the expense of a lower positive predictive value (PPV) of referral (25.8% vs. 39.6%, p < 0.001). These parameters were comparable for FFDM-SFM and FFDM-FFDM. Ductal carcinoma in situ (DCIS) and invasive cancer rates increased during transition and remained stable after transition. The rate of DCIS of intermediate grade increased during the transition from 0.2 per 1,000 screened women at SFM-SFM to 0.6 at FFDM-SFM (p < 0.001) and 0.5 at FFDM-FFDM (p 5 0.001). Compared to SFM-SFM, a significantly higher rate of invasive cancers were stage T1a-b at FFDM-SFM (p < 0.001) and FFDM-FFDM (p < 0.001). Breast conserving surgery rates increased during transition (p < 0.001) and remained stable afterwards. The CDR and referral rate remained significantly higher at FFDM than at SFM, at the expense of a decreased PPV of referral. During transition, DCIS was more often of intermediate grade and invasive cancers were of smaller size.Full-field digital mammography (FFDM) has replaced screenfilm mammography (SFM) in most breast cancer screening programs. FFDM improves workflow and there is emerging evidence that digital mammography is superior to SFM with respect to cancer detection, especially in women under the age of 50 years and in women with radiographically dense breasts. 1,2Previous studies have shown conflicting results when comparing SFM and FFDM outcome at screening mammography. Certain studies report no differences in cancer detection rates (CDRs), 3-5 whereas others find an increased 6-8 or decreased CDR 9 at FFDM. Higher CDRs at digital screening usually come with higher referral rates.10 Reports on the impact of FFDM on the positive predictive value (PPV) of referral also vary, but higher referral rates at digital mammography usually increased the number of women falsely referred. 7,11,12 Studies on the effect of the transition to FFDM on the pathology of breast cancer found at breast cancer screening have also shown conflicting results. Early studies have shown that the increased detection of breast cancer at FFDM was predominantly due to the detection of higher detection rates of ductal carcinoma in situ (DCIS). This observation intensified the discussion about over-diagnosis at screening mammography, that is, the detection of slow-growing tumours that would rarely have caused symptoms let alone death. 12-14On the other hand, several recent studies suggest that digital mammography appears to add to the detection of hi...

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Comparison of Digital Mammography and Screen-Film Mammography in Breast Cancer Screening: A Review in the Irish Breast Screening Program

Cited by 110 publications

References 20 publications

The impact of simulated motion blur on lesion detection performance in full-field digital mammography

The impact of simulated motion blur on lesion detection performance in full-field digital mammography

Is full field digital mammography equivalent in performance to screen film mammography? UK perspective

Screening outcome and surgical treatment during and after the transition from screen‐film to digital screening mammography in the south of The Netherlands

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