[Impact of digital mammography in the detection and management of microcalcifications].
OBJECTIVE
To determine whether the introduction of digital mammography in breast cancer screening has resulted in changes in the detection and management of microcalcifications.


METHODS
We retrospectively studied the performance indicators of our breast cancer screening program that are related to the diagnosis of microcalcifications (rates of recall and recommendation of intermediate follow-up after screening, rate of indication of invasive procedures for microcalcifications and their positive predictive value, detection rate for microcalcifications, and number of ductal carcinomas in situ (DCIS) diagnosed). We compared the results obtained using direct digital mammography (september 2008-august 2009) with those obtained using analog mammography (September 2006-August 2007).


METHODS
Chi-square test and measures of association.


RESULTS
We found that using digital mammography led to significant increases in the recall rate (from 50.8 to 64‰), in the rate of intermediate follow-up after screening (from 9.41 to 18.7‰), in the rate of indication for invasive procedures (from 1.88 to 3.01‰), in the cancers detected through microcalcifications (from 0.86 to 1.36‰), and in the number of DCIS diagnosed.


CONCLUSIONS
Direct digital mammography has improved the detection of microcalcifications, increasing the number of DCIS diagnosed without decreasing the positive predictive value of the invasive procedures indicated for microcalcifications. However, direct digital mammography has had a negative effect by increasing the recall rate and indication for short-term follow-up, possibly due to the difficulty of comparing the findings with those of earlier analog mammograms.
Servicio de Radiología, Complejo Hospitalario de Navarra, Pamplona, Navarra, España. mmelladr@cfnavarra.es
M
M
Mellado
A M
AM
Osa
A
A
Murillo
R
R
Bermejo
A
A
Burguete
M J
MJ
Pons
N
N
Erdozain
D001941:Breast Diseases / Q000000981:diagnostic imaging* / Q000628:therapy; D001943:Breast Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000150:complications / Q000000981:diagnostic imaging*; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D011856:Radiographic Image Enhancement; D012189:Retrospective Studies