title: Does digital mammography in a decentralized breast cancer screening program lead to screening performance parameters comparable with film-screen mammography?
abstract: OBJECTIVE
  To evaluate if the screening performance parameters of digital mammography (DM) in a decentralized screening organization were comparable with film-screen mammography (FSM).
  
  
  METHODS
  A nationwide screening program was launched in 2001, and since 2005 screening with DM has been allowed. Firstly, the parameters of the three regional screening units (RSUs) that first switched to DM (11,355 women) were compared with the FSM period of the same three RSUs (23,325 women). Secondly, they were compared with the results of the whole central breast unit (CBU).
  
  
  RESULTS
  The recall rate (RR) of the DM group in the initial round was 2.64% [2.40% for FSM (p = 0.43)] and in the subsequent round 1.20% [1.58% for FSM (p = 0.03)]. The cancer detection rate (CDR) was 0.59% for DM and 0.64% for FSM (p = 0.56). The percentage of ductal carcinoma in situ was 0.07% for DM and 0.16% for FSM (p = 0.02). The positive predictive value was high in the subsequent rounds (DM 48.00%, FSM 45.93%) and lower in the initial round (DM 24.05%, FSM 24.86%). Compared with the results of the whole CBU, DM showed no significant difference.
  
  
  CONCLUSIONS
  DM can be introduced in a decentralized screening organization with a high CDR without increasing the RR.
authors.affiliation: Department of Radiology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. chantal.vanongeval@uz.kuleuven.ac.be
authors.forename: Chantal
authors.initials: C
authors.lastname: Van Ongeval
authors.forename: Andre
authors.initials: A
authors.lastname: Van Steen
authors.forename: Gretel
authors.initials: G
authors.lastname: Vande Putte
authors.forename: Federica
authors.initials: F
authors.lastname: Zanca
authors.forename: Hilde
authors.initials: H
authors.lastname: Bosmans
authors.forename: Guy
authors.initials: G
authors.lastname: Marchal
authors.forename: Erik
authors.initials: E
authors.lastname: Van Limbergen
mesh_terms: D000368:Aged; D001530:Belgium; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000473:pathology; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D008403:Mass Screening; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods
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