title: Ductal carcinoma in situ: computer-aided detection in screening mammography.
abstract: OBJECTIVE
  To retrospectively evaluate the sensitivity of computer-aided detection (CAD) in depicting ductal carcinoma in situ (DCIS) on screening mammograms by using biopsy proved lesion location as the reference standard.
  
  
  METHODS
  Institutional review board approval was obtained, with a waiver of patient informed consent for this HIPAA-compliant study. Findings of all image-guided biopsies with a pathologic diagnosis of DCIS during a 1-year period were reviewed. Fifty-eight lesions in 55 women (average age, 61.41 years +/- 12.89 [standard deviation]) were available for review. The screening mammogram of the affected breast and, if available, the prior screening mammogram were digitized by the CAD system. An assessment was then made as to whether the CAD system marked the area of DCIS on the current and prior mammograms. Patient age, location and mammographic size of the lesion, type of lesion, and breast density were recorded and were analyzed by using chi2, Fisher exact, or Cochran-Mantel-Haenzel tests, where applicable.
  
  
  RESULTS
  CAD identified DCIS in 53 (91%) of 58 lesions on craniocaudal (CC) and mediolateral oblique (MLO) views of screening mammograms obtained in the year of the diagnosis. On screening mammograms obtained prior to the year of the diagnosis (34 patients), no radiologically or CAD-detected lesion was present on 11 (32%) of 34 mammograms. CAD identified DCIS in 16 (70%) of 23 lesions on one of the two views. Seven (30%) of 23 lesions had mammographic findings at retrospective review that were not identified with CAD.
  
  
  CONCLUSIONS
  CAD had a high sensitivity in the depiction of DCIS.
authors.affiliation: Department of Diagnostic Radiology, William Beaumont Hospital, 3601 W Thirteen Mile Rd, Royal Oak, MI 48073, USA.
authors.forename: Vidya R
authors.initials: VR
authors.lastname: Pai
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Gregory
authors.forename: Ann E
authors.initials: AE
authors.lastname: Swinford
authors.forename: Murray
authors.initials: M
authors.lastname: Rebner
mesh_terms: D001706:Biopsy; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D002278:Carcinoma in Situ / Q000000981:diagnostic imaging* / Q000473:pathology; D044584:Carcinoma, Ductal / Q000000981:diagnostic imaging* / Q000473:pathology; D016009:Chi-Square Distribution; D003951:Diagnostic Errors / Q000517:prevention & control; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D012680:Sensitivity and Specificity