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Digital mammography associated with lower recall, biopsy rates
Population-based screening with full-field digital mammography was associated with lower recall and biopsy rates than screen-film mammography, according to study results.
Full-field digital mammography (FFDM) also demonstrated higher positive predictive values, researchers wrote.
Solveig Hofvind, PhD, of the Cancer Registry of Norway and Oslo University College, and colleagues evaluated results of mammograms performed on women aged 50 to 69 years who were enrolled in the Norwegian Breast Cancer Screening Program from 1996 to 2010. The analysis included 1.39 million screen-film mammograms (SFM) and 446,172 FFDM examinations.
Researchers assessed data with the x2 test, which measured the equality of proportions of recall rates, as well as the positive predictive value of recall examinations and invasive procedures. Statistical analysis compared rates of screening-detected and interval cancers in women initially screened with SFM and FFDM, and for women subsequently screened with SF after SFM, FFDM after SFM, and FFDM after FFDM.
Researchers calculated a recall rate was 3.4% (n=47,091) for SFM and 2.9% (n=13,130) for FFDM (P=.001). The biopsy rate was 1.4% (n=19,776) for SFM and 1.1% (n=5108) for FFDM (P=.001).
The FFDM-detected rate of screening-detected ductal carcinoma in situ was higher (P=.019) than that for SFM, but the rate of invasive breast cancer detection was lower (P<.001) for FFDM. The rate of both invasive screening-detected and interval breast cancer remained stable during the transition from SFM to FFDM when the previous examination was SFM. The rate of both invasive screening-detected and interval breast cancer <25 months after FFDM remained firmly established (P<.05) when the previous examination was FFDM.
The positive predictive value (PPV) of recall examinations increased from 19.3% and 48.3%, and the PPV of invasive procedures increased from 22.7% to 57.5%, after adoption of FFDM (P<.001).
Authors of previous population-based studies that compared the accuracy of SFM and FFDM have demonstrated conflicting results with regard to age-specific performance, researchers noted. Findings from this study highlight the need for continued evaluation as FFDM technology is adopted.
“Performance evaluation of new breast imaging screening technologies should account for the transitional phase of adoption and the modality of prior comparison examinations,” the study said.
Disclosure: The researchers report no relevant financial disclosures.
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