DM's higher sensitivity at detecting breast cancer raised concerns that its introduction into screening programs would increase the diagnosis of clinically unimportant cancers—cancers that, if left undetected and therefore untreated, would never have surfaced clinically in the person's lifetime.
Data analysis showed an increased incidence of ductal carcinoma in situ (DCIS), a precursor for invasive breast cancer, in the years after the introduction of population-based screening with DM. The development of low-grade DCIS can extend over more than three decades; however, high-grade DCIS is associated with far more rapid cancer invasion.
"More DCIS and invasive cancers are detected with the use of DM in breast cancer screening compared to SFM," said Adriana M.J. Bluekens, M.D., from the National Expert and Training Centre for Breast Cancer Screening in Nijmegen and St. Elisabeth Hospital in Tilburg, both in the Netherlands. "In the mix of low- to high-grade DCIS lesions, there is no shift to the detection of low-grade lesions in digital screening. Instead of this, we noticed a larger amount of high-grade lesions, which are regarded as precursors of high-grade invasive tumors."
To learn more about the impact of DM on screening programs, Dutch researchers compared it with SFM in screening mammograms performed between 2003 and 2007. Recall was indicated in 18,896 cases out of almost two million mammograms studied, and 6,410 women were diagnosed with breast cancer. As expected, DM had a higher initial sensitivity for detecting cancer, with a detection rate per thousand of 6.8, compared with 5.6 for SFM.
Detection of high-grade DCIS with DM was 58.5 percent, compared with 50.5 percent for SFM.
"This gain is largely due to enhanced depiction of microcalcifications with DM resulting in improved detection of DCIS and invasive carcinoma with an intraductal component," Dr. Bluekens said.
The initial recall rate was higher with DM: 4.4 percent, compared with 2.6 percent for SFM. However, the transition to digital mammography did not result in a disproportionate increase in low-grade DCIS lesions, which are linked to possible overdiagnosis.
The findings provide further evidence of the benefits of population-based breast cancer screening programs that use DM, according to Dr. Bluekens.
"The follow-up period of the different digital screening programs is not sufficiently long enough to analyze mortality effect separately from that of SFM," she noted. "However, surrogate parameters, such as stage distribution and tumor characteristics of DM-detected cancers, do indicate the continuation of mortality decrease with the transformation of SFM to DM in screening programs."
Researchers cautioned that the results were based on analysis of data from the Dutch screening program, with its focus on balancing the rates of detection, recall and false-positives. Numbers from the U.S. screening program, which focuses more on a high detection rate, would likely be different.
"Comparison of Digital Screening Mammography and Screen-Film Mammography in the Early Detection of Clinically Relevant Cancers: A Multicenter Study." Collaborating with Dr. Bluekens were Roland Holland, M.D., Ph.D., Nico Karssemeijer, Ph.D., Mireille J.M. Broeders, Ph.D., and Gerard J den Heeten, M.D., Ph.D.
Radiology is edited by Herbert Y. Kressel, M.D., Harvard Medical School, Boston, Mass., and owned and published by the Radiological Society of North America, Inc. (http://radiology.rsna.org/)
RSNA is an association of more than 50,000 radiologists, radiation oncologists, medical physicists and related scientists promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Ill. (RSNA.org)
For patient-friendly information on mammography, visit RadiologyInfo.org.
Novel PET imaging agent could help guide therapy for brain diseases
03.04.2018 | Society of Nuclear Medicine and Molecular Imaging
New Computer Architecture: Time Lapse for Dementia Research
29.03.2018 | Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE)
At the Hannover Messe 2018, the Bundesanstalt für Materialforschung und-prüfung (BAM) will show how, in the future, astronauts could produce their own tools or spare parts in zero gravity using 3D printing. This will reduce, weight and transport costs for space missions. Visitors can experience the innovative additive manufacturing process live at the fair.
Powder-based additive manufacturing in zero gravity is the name of the project in which a component is produced by applying metallic powder layers and then...
Physicists at the Laboratory for Attosecond Physics, which is jointly run by Ludwig-Maximilians-Universität and the Max Planck Institute of Quantum Optics, have developed a high-power laser system that generates ultrashort pulses of light covering a large share of the mid-infrared spectrum. The researchers envisage a wide range of applications for the technology – in the early diagnosis of cancer, for instance.
Molecules are the building blocks of life. Like all other organisms, we are made of them. They control our biorhythm, and they can also reflect our state of...
University of Connecticut researchers have created a biodegradable composite made of silk fibers that can be used to repair broken load-bearing bones without the complications sometimes presented by other materials.
Repairing major load-bearing bones such as those in the leg can be a long and uncomfortable process.
Study published in the journal ACS Applied Materials & Interfaces is the outcome of an international effort that included teams from Dresden and Berlin in Germany, and the US.
Scientists at the Helmholtz-Zentrum Dresden-Rossendorf (HZDR) together with colleagues from the Helmholtz-Zentrum Berlin (HZB) and the University of Virginia...
Novel highly efficient and brilliant gamma-ray source: Based on model calculations, physicists of the Max PIanck Institute for Nuclear Physics in Heidelberg propose a novel method for an efficient high-brilliance gamma-ray source. A giant collimated gamma-ray pulse is generated from the interaction of a dense ultra-relativistic electron beam with a thin solid conductor. Energetic gamma-rays are copiously produced as the electron beam splits into filaments while propagating across the conductor. The resulting gamma-ray energy and flux enable novel experiments in nuclear and fundamental physics.
The typical wavelength of light interacting with an object of the microcosm scales with the size of this object. For atoms, this ranges from visible light to...
13.04.2018 | Event News
12.04.2018 | Event News
09.04.2018 | Event News
24.04.2018 | Life Sciences
24.04.2018 | Materials Sciences
24.04.2018 | Trade Fair News