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.
Wireless power can drive tiny electronic devices in the GI tract
28.04.2017 | Brigham and Women's Hospital
Artificial intelligence may help diagnose tuberculosis in remote areas
25.04.2017 | Radiological Society of North America
More and more automobile companies are focusing on body parts made of carbon fiber reinforced plastics (CFRP). However, manufacturing and repair costs must be further reduced in order to make CFRP more economical in use. Together with the Volkswagen AG and five other partners in the project HolQueSt 3D, the Laser Zentrum Hannover e.V. (LZH) has developed laser processes for the automatic trimming, drilling and repair of three-dimensional components.
Automated manufacturing processes are the basis for ultimately establishing the series production of CFRP components. In the project HolQueSt 3D, the LZH has...
Reflecting the structure of composites found in nature and the ancient world, researchers at the University of Illinois at Urbana-Champaign have synthesized thin carbon nanotube (CNT) textiles that exhibit both high electrical conductivity and a level of toughness that is about fifty times higher than copper films, currently used in electronics.
"The structural robustness of thin metal films has significant importance for the reliable operation of smart skin and flexible electronics including...
The nearby, giant radio galaxy M87 hosts a supermassive black hole (BH) and is well-known for its bright jet dominating the spectrum over ten orders of magnitude in frequency. Due to its proximity, jet prominence, and the large black hole mass, M87 is the best laboratory for investigating the formation, acceleration, and collimation of relativistic jets. A research team led by Silke Britzen from the Max Planck Institute for Radio Astronomy in Bonn, Germany, has found strong indication for turbulent processes connecting the accretion disk and the jet of that galaxy providing insights into the longstanding problem of the origin of astrophysical jets.
Supermassive black holes form some of the most enigmatic phenomena in astrophysics. Their enormous energy output is supposed to be generated by the...
The probability to find a certain number of photons inside a laser pulse usually corresponds to a classical distribution of independent events, the so-called...
Microprocessors based on atomically thin materials hold the promise of the evolution of traditional processors as well as new applications in the field of flexible electronics. Now, a TU Wien research team led by Thomas Müller has made a breakthrough in this field as part of an ongoing research project.
Two-dimensional materials, or 2D materials for short, are extremely versatile, although – or often more precisely because – they are made up of just one or a...
28.04.2017 | Event News
20.04.2017 | Event News
18.04.2017 | Event News
28.04.2017 | Medical Engineering
28.04.2017 | Earth Sciences
28.04.2017 | Life Sciences