Digital Mammography Screening: Association between Detection Rate and Nuclear Grade of Ductal Carcinoma in Situ

Weigel, Stefanie; Heindel, Walter; Heidinger, Oliver; Berkemeyer, Shoma; Hense, Hans Werner

doi:10.1148/radiol.13131498

Cited by 25 publications

(25 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…De Gelder estimated that less than 10% of all cancers detected at digital mammography screening in The Netherlands would be over‐diagnosed . In line with our findings, recent studies demonstrated that digital mammography increases the detection of smaller invasive cancers and DCIS, with the latter particularly of intermediate—and high—grade subtypes that carry a higher risk of transition to invasive cancer …”

Section: Discussionsupporting

confidence: 89%

“…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 . On the other hand, several recent studies suggest that digital mammography appears to add to the detection of high‐grade DCIS subtypes that carry a higher risk of transition to invasive cancer …”

mentioning

confidence: 99%

“…[12][13][14] On the other hand, several recent studies suggest that digital mammography appears to add to the detection of high-grade DCIS subtypes that carry a higher risk of transition to invasive cancer. [15][16][17] The aim of this study was to determine screening outcome and surgical treatment at subsequent rounds during and after the transition from screen-film to FFDM in a southern breast cancer screening region of The Netherlands.…”

mentioning

confidence: 99%

See 2 more Smart Citations

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

View full text Add to dashboard Cite

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...

show abstract

Section: Discussionsupporting

confidence: 89%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

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

View full text Add to dashboard Cite

show abstract

“…Our study examines cancer detection and does not investigate whether there is a clinical benefit to the higher cancer detection rate associated with DR systems. However, Weigel et al (25) have shown that where there were variations in overall cancer detection rates in screening, this was due to differences in all types of cancers and not just in low risk groups. This suggests that high cancer detection in screening is beneficial.…”

Section: Discussionmentioning

confidence: 99%

Breast cancer detection rates using four different types of mammography detectors

et al. 2015

View full text Add to dashboard Cite

Objectives To compare the performance of different types of detectors in breast cancer detection. Methods A mammography image set containing subtle malignant non-calcification lesions, biopsy-proven benign lesions, simulated malignant calcification clusters and normals was acquired using amorphous-selenium (a-Se) detectors. The images were adapted to simulate four types of detectors at the same radiation dose: digital radiography (DR) detectors with a-Se and caesium iodide (CsI) convertors, and computed radiography (CR) detectors with a powder phosphor (PIP) and a needle phosphor (NIP). Seven observers marked suspicious and benign lesions. Analysis was undertaken using jackknife alternative free-response receiver operating characteristics weighted figure of merit (FoM). The cancer detection fraction (CDF) was estimated for a representative image set from screening. Results No significant differences in the FoMs between the DR detectors were measured. For calcification clusters and non-calcification lesions, both CR detectors’ FoMs were significantly lower than for DR detectors. The calcification cluster’s FoM for CR NIP was significantly better than for CR PIP. The estimated CDFs with CR PIP and CR NIP detectors were up to 15% and 22% lower respectively than for DR detectors. Conclusion Cancer detection is affected by detector type and the use of CR in mammography should be reconsidered.

show abstract

“…The epidemiology of breast cancer has changed alongside technical improvements in breast radiology that result in more lesions being identified, investigated and treated than was the case in the era of the original screening trials [13]. The simple truth is that the magnitude of overtreatment today as a result of breast screening remains difficult to accurately estimate.…”

Section: Contents Lists Available At Sciencedirectmentioning

confidence: 99%

The LORIS Trial: Addressing Overtreatment of Ductal Carcinoma In Situ

2015

View full text Add to dashboard Cite

Digital Mammography Screening: Association between Detection Rate and Nuclear Grade of Ductal Carcinoma in Situ

Cited by 25 publications

References 16 publications

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

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

Breast cancer detection rates using four different types of mammography detectors

The LORIS Trial: Addressing Overtreatment of Ductal Carcinoma In Situ

Contact Info

Product

Resources

About