title: Screening mammography-detected cancers: sensitivity of a computer-aided detection system applied to full-field digital mammograms.
abstract: OBJECTIVE
  To retrospectively evaluate the sensitivity of the performance of a computer-aided detection (CAD) system applied to full-field digital mammograms for detection of breast cancers in a screening group, with histologic findings as the reference standard.
  
  
  METHODS
  This study had institutional review board approval, and patient informed consent was waived. A commercially available CAD system was applied to the digital mammograms of 103 women (mean age, 51 years; range, 35-69 years) with 103 breast cancers detected with screening. Sensitivity values of the CAD system according to mammographic appearance, breast composition, and histologic findings were analyzed. Normal mammograms from 100 women (mean age, 54 years; age range, 35-75 years) with no mammographic and clinical abnormality during 2-year follow-up were used to determine false-positive CAD system marks. Differences between the cancer detection rates in fatty and dense breasts for the CAD system were compared by using the chi(2) test.
  
  
  RESULTS
  The CAD system correctly marked 99 (96.1%) of 103 breast cancers. The CAD system marked all 44 breast cancers that manifested as microcalcifications only, all 23 breast cancers that manifested as a mass with microcalcifications, and 32 (89%) of 36 lesions that appeared as a mass only. The sensitivity of the CAD system in the fatty breast group was 95% (59 of 62) and in the dense breast group was 98% (40 of 41) (P = .537). The CAD system correctly marked all 31 lesions of ductal carcinoma in situ (DCIS), all 22 lesions of invasive ductal carcinoma with DCIS, the single invasive lobular carcinoma lesion, and 45 (92%) of 49 lesions of invasive ductal carcinoma. On normal mammograms, the mean number of false-positive marks per patient was 1.80 (range, 0-10 marks; median, 1 mark).
  
  
  CONCLUSIONS
  The CAD system can correctly mark most (96.1%) asymptomatic breast cancers detected with digital mammographic screening, with acceptable false-positive marks (1.80 per patient).
authors.affiliation: Department of Radiology and Clinical Research Institute, Seoul National University Hospital and the Institute of Radiation Medicine, Seoul National University Medical Research Center, 28 Yongon-dong, Chongno-gu, Seoul 100-744, Korea.
authors.forename: Sang Kyu
authors.initials: SK
authors.lastname: Yang
authors.forename: Woo Kyung
authors.initials: WK
authors.lastname: Moon
authors.forename: Nariya
authors.initials: N
authors.lastname: Cho
authors.forename: Jeong Seon
authors.initials: JS
authors.lastname: Park
authors.forename: Joo Hee
authors.initials: JH
authors.lastname: Cha
authors.forename: Sun Mi
authors.initials: SM
authors.lastname: Kim
authors.forename: Seung Ja
authors.initials: SJ
authors.lastname: Kim
authors.forename: Jung-Gi
authors.initials: JG
authors.lastname: Im
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D016009:Chi-Square Distribution; D003937:Diagnosis, Differential; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D011856:Radiographic Image Enhancement; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D012680:Sensitivity and Specificity