The impact of digital mammography on screening a young cohort of women for breast cancer in an urban specialist breast unit.
OBJECTIVE
To compare the diagnostic performance of full-field digital mammography (FFDM) with screen-film mammography (SFM) in a corporate screening programme including younger women.


METHODS
Data were available on 14,946 screening episodes, 5010 FFDM and 9936 SFM. Formal analysis was by logistic regression, adjusting for age and calendar year. FFDM is compared with SFM with reference to cancer detection rates, cancers presenting as clustering microcalcifications, recall rates and PPV of recall.


RESULTS
Overall detection rates were 6.4 cancers per thousand screens for FFDM and 2.8 per thousand for SFM (p < 0.001). In women aged 50+ cancer detection was significantly higher for FFDM at 8.6 per thousand vs. 4.0 per thousand, (p = 0.002). In women <50, cancer detection was also significantly higher for FFDM at 4.3 per thousand vs. 1.4 per thousand, (p = 0.02). Cancers detected as clustering microcalcifications increased from 0.4 per thousand with SFM to 2.0 per thousand with FFDM. Rates of assessment recall were higher for FFDM (7.3% vs. 5.0%, p < 0.001). FFDM provided a higher PPV for assessment recall, (32 cancers/364 recalls, 8.8%) than SFM, (28 cancers/493 recalls, 5.7%).


CONCLUSIONS
Cancer detection rates were significantly higher for FFDM than for SFM, especially for women <50, and cancers detected as clustering microcalcifications.
Perry
Nicholas M
NM
The London Breast Institute, The Princess Grace Hospital, 45 Nottingham Place, London W1U 5NY, UK. doctor_nickperry@hotmail.com
Patani
N
N
Milner
S E
SE
Pinker
K
K
Mokbel
K
K
Allgood
P C
PC
Duffy
S W
SW
D000328:Adult; D000368:Aged; D000465:Algorithms; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D002114:Calcinosis / Q000000981:diagnostic imaging; D016000:Cluster Analysis; D015331:Cohort Studies; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011856:Radiographic Image Enhancement / Q000379:methods; D014463:Ultrasonography; D014505:Urban Population