Comparative evaluation of digital mammography and film mammography: systematic review and meta-analysis

Abstract

CONTEXT AND OBJECTIVE: Mammography is the best method for breast-cancer screening and is capable of reducing mortality rates. Studies that have assessed the clinical impact of mammography have been carried out using film mammography. Digital mammography has been proposed as a substitute for film mammography given the benefits inherent to digital technology. The aim of this study was to compare the performance of digital and film mammography. DESIGN: Systematic review and meta-analysis. METHOD: The Medline, Scopus, Embase and Lilacs databases were searched looking for paired studies, cohorts and randomized controlled trials published up to 2009 that compared the performance of digital and film mammography, with regard to cancer detection, recall rates and tumor characteristics. The reference lists of included studies were checked for any relevant citations. RESULTS: A total of 11 studies involving 190,322 digital and 638,348 film mammography images were included. The cancer detection rates were significantly higher for digital mammography than for film mammography (risk relative, RR = 1.17; 95% confidence interval, CI = 1.06-1.29; I² = 19%). The advantage of digital mammography seemed greatest among patients between 50 and 60 years of age. There were no significant differences between the two methods regarding patient recall rates or the characteristics of the tumors detected. CONCLUSION: The cancer detection rates using digital mammography are slightly higher than the rates using film mammography. There are no significant differences in recall rates between film and digital mammography. The characteristics of the tumors are similar in patients undergoing the two methods.

Methodological quality of systematic reviews and clinical trials on women's health published in a Brazilian evidence-based health journal

“…All SRs were on gynecological topics: teriparatide for osteoporosis in post-menopausal women (10), lapatinib for advanced or metastasized breast cancer (11), comparative evaluation of digital mammography and film mammography (12), colposcopic triage methods for grade 3 cervical intraepithelial neoplasia (CIN3) after a cytopathological diagnosis of a low-grade squamous intraepithelial lesion (13) and risk of persistent high-grade squamous intraepithelial lesion after an electrosurgical excision with positive margins (14). Three of the reviews focused on treatment (10,11,14), and two focused on diagnosis (12,13). Three of these SRs presented meta-analyses of their results (10,13,14).…”

Breast Cancer Screening

“…In screen-film mammography, images were developed and fixed chemically, a process similar to film photography. Processing errors led to > 20 percent of images being rejected, 10 resulting in repeat imaging which increased examination time, exposure to ionizing radiation, and costs. In the U.S., screen-film mammography has now largely been replaced by full-field digital mammography.…”

Budget Impact Analysis of Switching to Digital Mammography in a Population-Based Breast Cancer Screening Program: A Discrete Event Simulation Model

“…This percentage was applied to the overall number of interval cancers in the 20-year period and sensitivity was calculated. Sensitivity was assumed to be similar for both techniques [10]–[13] but was modeled as a probabilistic parameter and was sampled separately for each technique using the same statistical distribution with a mode of 86.66%. This allowed us to obtain scenarios with similar and different sensitivities favoring digital or screen-film mammography (see appendix S1).…”

“…The US Preventive Services Task Force recommendations [9], however, were based on the results of screening with screen-film mammography and consider that there is insufficient evidence to recommend digital mammography. The existing evidence on the effect of digital mammography in population-based breast cancer screening programs indicators is inconclusive: although the latest studies have found a slightly higher detection rate (number of cancers detected per 1,000 examinations) with digital mammography [10], the main conclusion of review studies is that digital mammography is at least as good as screen-film [11]–[13]. Recent studies in Spain [14]–[16] have found a lower recall rate (percentage of women called back for further tests) for digital mammography and a similar cancer detection rate.…”