The value of computer aided detection system for mammography in the fatty breast: the results of the single-centered, prospective, randomized clinical trial

Abstract

Aim. To assess the reasonability to use CAD added to mammography with subsequent targeted ultrasound (US) of CAD markings in patients with low-density (ACR A-В) breasts.Materials and methods. In the prospective study we included 2326 women with low breast density. They were randomized for CAD (MammCheck II of our own design) checking with subsequent targeted US (MMG + CAD group) or without CAD (MMG only group). After the initial screening we performed the 3-year follow-up phase.Results. Totally, during the primary screening in the MMG only group we found 77 breast cancers (BCs) (28,57% of them sized less than 1 cm), in the MMG + CAD group – 69 BCs (36,23% of them sized less than 1 cm), р > 0.05. The suspicious lesion was identified only during the targeted US of the CAD marking in 4 of 25 women in the MMG + CAD group, and all these BCs were below 1 cm in size. During the subsequent follow-up in the MMG only group we found 5 additional BCs, with no such cases in the MMG + CAD group (p < 0.05). Three of these five BCs were retrospectively marked by CAD. The only visible BC that was not marked by CAD was 3 mm in size.Discussion. The overall false positive marking rate was 0.31 и 0.28 per film-screen and digital image, respectively (р > 0.05).Conclusion. The CAD usage added to mammography with subsequent targeted US of markings in patients with low-density (ACR A-В) breast is reasonable due to the significant decrease of the BC rate diagnosed during the 3-year follow-up. This combination detected 77 of the 77 (100.00%) BCs compared to 69 of 74 (93.24%) BCs when only mammography used.