Digital Mammography Tops Screen-Film for Screening

Improves detection of DCIS and invasive cancer without increasing potential for overdiagnosis

TUESDAY, Oct. 2 (HealthDay News) -- Compared with screen-film mammography, digital mammography substantially improved the detection of ductal carcinoma in situ (DCIS) and invasive carcinoma, particularly when associated with microcalcifications, without an increase in clinically insignificant lesions, according to a study published online Oct. 2 in Radiology.

Adriana M.J. Bluekens, M.D., of the National Expert and Training Centre for Breast Cancer Screening in Nijmegen, Netherlands, and colleagues conducted a multicenter, population-based study involving 1,198,493 breast cancer screening examinations conducted between 2003 and 2007 to compare the clinical relevance of detected cancers using screen-film and digital mammography.

A total of 6,410 women had breast cancer. At the initial examination, the researchers found that screen-film mammography detected 5.6 cases of breast cancer per 1,000, compared with 6.8 per 1,000 with digital mammography. At subsequent examinations, 5.2 cases per 1,000 were detected with screen-film and 6.1 with digital mammography. Significantly more DCIS, particularly high-grade DCIS lesions, were detected using digital compared with screen-film mammography. Invasive carcinomas, particularly those associated with microcalcifications, were detected significantly more often in subsequent examinations using digital mammography.

"The performance of digital mammography in the detection of DCIS and invasive carcinoma was substantially better than that of screen-film mammography," the authors write. "There is no sign of an increase in detection of low-grade DCIS lesions -- indicative of possible overdiagnosis -- with digital breast cancer screening. Rather, digital mammography appears to add to the detection of high-grade DCIS."

Several authors disclosed financial ties to the medical technology industry.

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