Comparison of Direct Digital Mammography, Computed Radiography, and Film-Screen in the French National Breast Cancer Screening Program
- 1 January 2014
- journal article
- research article
- Published by American Roentgen Ray Society in American Journal of Roentgenology
- Vol. 202 (1), 229-236
- https://doi.org/10.2214/ajr.12.10419
Abstract
The purpose of this article was to compare the performance of digital mammography using hardcopy image reading against film-screen mammography in a French national routine population-based screening program with a decentralized organization. The French context offered the opportunity to examine separately computed radiography and direct digital mammography performances in a large cohort. The study includes 23,423 direct digital mammography, 73,320 computed radiography, and 65,514 film-screen mammography examinations performed by 123 facilities in Bouches du Rhône, France, for women 50-74 years old between 2008 and 2010. We compared abnormal mammography findings rate, cancer detection rate, and tumor characteristics among the technologies. Abnormal finding rates were higher for direct digital mammography (7.78% vs 6.11% for film-screen mammography and 5.34% for computed radiography), particularly in younger women and in denser breasts. Cancer detection rates were also higher for direct digital mammography (0.71% vs 0.66% for film-screen mammography and 0.55% for computed radiography). The contrast between detection rates was stronger for ductal carcinoma in situ. Breast density was the main factor explaining the differences in detection rates. For direct digital mammography only, the detection rate was clearly higher in dense breasts whatever the age (odds ratio, 2.20). Except for grade, no differences were recorded concerning tumor characteristics in which the proportion of high-grade tumors was larger for direct digital mammography for invasive and in situ tumors. Direct digital mammography has a higher detection rate than film-screen mammography in dense breasts and for tumors of high grade. This latter association warrants further study to measure the impact of technology on efficacy of screening. The data indicate that computed radiography detects fewer tumors than film-screen mammography in most instances.Keywords
This publication has 27 references indexed in Scilit:
- Digital mammography in a screening programme and its implications for pathology: a comparative studyJournal of Clinical Pathology, 2010
- Consequences of digital mammography in population-based breast cancer screening: initial changes and long-term impact on referral ratesEuropean Radiology, 2010
- Comparison of Digital Mammography and Screen-Film Mammography in Breast Cancer Screening: A Review in the Irish Breast Screening ProgramAmerican Journal of Roentgenology, 2009
- Diagnostic Accuracy of Digital versus Film Mammography: Exploratory Analysis of Selected Population Subgroups in DMISTRadiology, 2008
- Digital versus screen-film mammography: A retrospective comparison in a population-based screening programEuropean Journal of Radiology, 2007
- Full-Field Digital Versus Screen-Film Mammography: Comparative Accuracy in Concurrent Screening CohortsAmerican Journal of Roentgenology, 2007
- Issues to Consider in Converting to Digital MammographyRadiologic Clinics of North America, 2007
- Dépistage organisé des Cancers du Sein : peut-on comparer les résultats du programme français aux résultats internationaux ?Journal de Radiologie, 2006
- Diagnostic Performance of Digital versus Film Mammography for Breast-Cancer ScreeningThe New England Journal of Medicine, 2005
- Categorizing breast mammographic density: intra- and interobserver reproducibility of BI-RADS density categoriesThe Breast, 2005