Does digital mammography in a decentralized breast cancer screening program lead to screening performance parameters comparable with film-screen mammography?

Ongeval, Chantal Van; Steen, Andreas Van; Putte, Gretel Vande; Zanca, Federica; Bosmans, Hilde; Marchal, Guy; Limbergen, Erik

doi:10.1007/s00330-010-1807-6

Cited by 18 publications

(7 citation statements)

References 19 publications

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“…Similar to our findings, one previous study also showed lower cancer detection rates for DM (DR and CR systems) at subsequent screening examinations; however, that finding did not reach statistical significance (26). Furthermore, we found that cancer detection rates for CR compared with SFM were significantly lower for women not currently using estrogen and postmenopausal women.…”

Section: Breast Imaging: Digital Versus Screen-film Mammography In Cosupporting

confidence: 91%

“…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%

See 1 more Smart Citation

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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Section: Breast Imaging: Digital Versus Screen-film Mammography In Cosupporting

confidence: 91%

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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“…However, MX is an imperfect tool in detecting breast cancer, with an overall sensitivity of 75%‐85%, dropping as low as 30%‐50% in women with a BRCA gene mutation . Specificity is limited, and the positive predictive value of a biopsy recommendation is in the 25%‐45% range . As many as 20%‐30% of breast cancers will not be detected on a mammogram .…”

Section: Introductionmentioning

confidence: 99%

“…Specificity is limited, and the positive predictive value of a biopsy recommendation is in the 25%‐45% range . As many as 20%‐30% of breast cancers will not be detected on a mammogram . Mammographic sensitivity decreases with the increasing of parenchyma density due to a superimposition of dense breast tissue on a two‐dimensional (2D) mammographic projection.…”

Section: Introductionmentioning

confidence: 99%

Digital breast tomosynthesis and contrast‐enhanced dual‐energy digital mammography alone and in combination compared to 2D digital synthetized mammography and MR imaging in breast cancer detection and classification

et al. 2019

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To compare diagnostic performance of contrast-enhanced dual-energy digital mammography (CEDM) and digital breast tomosynthesis (DBT) alone and in combination compared to 2D digital mammography (MX) and dynamic contrast-enhanced MRI (DCE-MRI) in women with breast lesions. We enrolled 100 consecutive patients with breast lesions (BIRADS 3-5 at imaging or clinically suspicious). CEDM, DBT, and DCE-MRI 2D were acquired. Synthetized MX was obtained by DBT. A total of 134 lesions were investigated on 111 breasts of 100 enrolled patients: 53 were histopathologically proven as benign and 81 as malignant. Nonparametric statistics and receiver operating characteristic (ROC) curve were performed. Two-dimensional synthetized MX showed an area under ROC curve (AUC) of 0.764 (sensitivity 65%, specificity 80%), while AUC was of 0.845 (sensitivity 80%, specificity 82%) for DBT, of 0.879 (sensitivity 82%, specificity 80%) for CEDM, and of 0.892 (sensitivity 91%, specificity 84%) for CE-MRI. DCE-MRI determined an AUC of 0.934 (sensitivity 96%, specificity 88%). Combined CEDM with DBT findings, we obtained an AUC of 0.890 (sensitivity 89%, specificity 74%). A difference statistically significant was observed only between DCE-MRI and CEDM (P = .03). DBT, CEDM, CEDM combined to tomosynthesis, and DCE-MRI had a high ability to identify multifocal and bilateral lesions with a detection rate of 77%, 85%, 91%, and 95% respectively, while 2D synthetized MX had a detection rate for multifocal lesions of 56%. DBT and CEDM have superior diagnostic accuracy of 2D synthetized MX to identify and classify breast lesions, and CEDM combined with DBT has better diagnostic performance compared with DBT alone. The best results in terms of diagnostic performance were obtained by DCE-MRI. Dynamic information obtained by time-intensity curve including entire phase of contrast agent uptake allows a better detection and classification of breast lesions. | 861 PETRILLO ET aL.

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“…1,2 Previous 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][4][5] whereas others find an increased [6][7][8] or decreased CDR 9 at FFDM. Higher CDRs at digital screening usually come with higher referral rates.…”

mentioning

confidence: 99%

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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Does digital mammography in a decentralized breast cancer screening program lead to screening performance parameters comparable with film-screen mammography?

Abstract: DM can be introduced in a decentralized screening organization with a high CDR without increasing the RR.

Cited by 18 publications

References 19 publications

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

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

Digital breast tomosynthesis and contrast‐enhanced dual‐energy digital mammography alone and in combination compared to 2D digital synthetized mammography and MR imaging in breast cancer detection and classification

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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