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

Domingo, Laia; Romero, Anabel; Belvis, Francesc; Sánchez, Mar; Ferrer, Joana; Salas, Dolores; Ibáñez, Josefa; Vega, Alfonso; Ferrer, Ferran; Laso, M. Soledad; Macià, Francesc; Castells, Xavier; Sala, María

doi:10.1007/s00330-011-2143-1

Cited by 34 publications

(34 citation statements)

References 27 publications

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“…A large number of studies have reported the superior detection of DCIS with digital than SFM. 60,[64][65][66][67][68] Among 200,000 females screened over a 6-year period, DCIS was accurately found in 0.09% of the females screened by digital means compared with 0.05% by SFM (p 5 0.010). 23 The most common radiographic appearance of DCIS is microcalcification.…”

Section: Screening Protocolmentioning

confidence: 95%

“…23 The most common radiographic appearance of DCIS is microcalcification. 60,66,69 A study demonstrating CAD's ability to identify 100% of cases presenting with microcalcifications provides a plausible explanation for the superior detection of benign and in situ lesions in the digital setting. 70 A meta-analysis assessing the use of CAD against the interpretation of soft-copy digital mammograms alone showed that CAD significantly elevated the FP rate by an additional 1.19% over the rate observed with unassisted reporting (11%).…”

Section: Screening Protocolmentioning

confidence: 99%

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Is the false-positive rate in mammography in North America too high?

Le¹,

Mothersill²,

Seymour³

et al. 2016

BJR

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The practice of investigating pathological abnormalities in the breasts of females who are asymptomatic is primarily employed using X-ray mammography. The importance of breast screening is reflected in the mortality-based benefits observed among females who are found to possess invasive breast carcinoma prior to the manifestation of clinical symptoms. It is estimated that population-based screening constitutes a 17% reduction in the breast cancer mortality rate among females affected by invasive breast carcinoma. In spite of the significant utility that screening confers in those affected by invasive cancer, limitations associated with screening manifest as potential harms affecting individuals who are free of invasive disease. Disease-free and benign tumour-bearing individuals who are subjected to diagnostic work-up following a screening examination constitute a population of cases referred to as false positives (FPs). This article discusses factors contributing to the FP rate in mammography and extends the discussion to an assessment of the consequences associated with FP reporting. We conclude that the mammography FP rate in North America is in excess based upon the observation of overtreatment of in situ lesions and the disproportionate distribution of detriment and benefit among the population of individuals recalled for diagnostic work-up subsequent to screening. To address the excessive incidence of FPs in mammography, we investigate solutions that may be employed to remediate the current status of the FP rate. Subsequently, it can be suggested that improvements in the breast-screening protocol, medical litigation risk, image interpretation software and the implementation of image acquisition modalities that overcome superimposition effects are promising solutions.

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Section: Screening Protocolmentioning

confidence: 95%

Section: Screening Protocolmentioning

confidence: 99%

Is the false-positive rate in mammography in North America too high?

Le¹,

Mothersill²,

Seymour³

et al. 2016

BJR

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show abstract

“…Of the studies that 3examined the effect of DM in breast screening programs (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27), five compared DM with SFM in concurrent cohorts (20,21,23,25,27), using mainly DR technology. Most found similar cancer detection rates (20,21,23) and positive predictive values (20,21,25) but also reported significantly higher recall rates for DM than for SFM (20,25).…”

Section: Study Populationmentioning

confidence: 99%

Digital Compared with Screen-Film Mammography: Performance Measures in Concurrent Cohorts within an Organized Breast Screening Program

Chiarelli¹,

Edwards²,

Prummel³

et al. 2013

Radiology

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“…The proportion of DCIS was also higher in digital mammography group than SFM in a study by Domingo et al [12] , although this difference was not significant. This is in agreement with many previous studies [5,8] as well as our own study.…”

Section: Discussionmentioning

confidence: 79%

“…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] . Accurate evaluation of risks and benefits of digital imaging in the screening environment is necessary at a time when the value of screening itself is questioned [13,14] .…”

Section: Introductionmentioning

confidence: 99%

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

Abstract: 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.

Cited by 34 publications

References 27 publications

Is the false-positive rate in mammography in North America too high?

Is the false-positive rate in mammography in North America too high?

Digital Compared with Screen-Film Mammography: Performance Measures in Concurrent Cohorts within an Organized Breast Screening Program

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

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