title: Screening outcome in women repeatedly recalled for the same mammographic abnormality before, during and after the transition from screen-film to full-field digital screening mammography.
abstract: OBJECTIVE
  The aim of this study was to retrospectively determine screening outcome in women recalled twice for the same mammographic lesion before, during, and after transition from screen-film (SFM) to full-field digital screening mammography (FFDM).
  
  
  METHODS
  We included women with a repeated recall for the same mammographic abnormality (37 at subsequent SFM-screening, obtained between January 2000-April 2010; respectively 54 and 65 women with a prior SFM-screen or FFDM-screen followed by subsequent FFDM-screening, obtained between May 2009-July 2013).
  
  
  RESULTS
  At SFM-screening, repeated recalls for the same lesion comprised 1.2 % of recalls (37/3217), including 13 malignancies (positive predictive value (PPV), 35.1 %). During the SFM to FFDM transition (SFM-screen followed by FFDM-screen), FFDM recalls comprised more repeated recalls for the same lesion (2.2 %, P = 0.002), with a lower PPV (14.8 %, P = 0.02). This proportion increased to 2.8 % after transition to FFDM (i.e., two successive FFDM-screens), with 16 malignancies (PPV, 24.6 %). Invasive cancers at repeated recall were smaller than interval cancers (T1a-c, 79.4 versus 46.8 %, P = 0.001), with less lymph node involvement (20.6 versus 46.5 %, P = 0.007).
  
  
  CONCLUSIONS
  More women are repeatedly recalled for the same mammographic abnormality during and after the transition from SFM to FFDM-screening, with comparable cancer risks before and after the transition. These cancers show better prognostic characteristics than interval cancers.
  
  
  CONCLUSIONS
  • FFDM-screening increases the number of repeated recalls for the same mammographic abnormality. • The PPV of these recalls is comparable before and after transition to FFDM-screening. • Cancers diagnosed after a repeated recall are smaller than interval cancers. • These cancers also show less lymph node involvement than interval cancers.
authors.affiliation: Department of Radiology, Catharina Hospital, PO Box 1530, 5602 ZA, Eindhoven, The Netherlands.
authors.forename: Rob
authors.initials: R
authors.lastname: van Bommel
authors.affiliation: Department of Epidemiology, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands.|Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), PO Box 19079, 3501 DB, Utrecht, The Netherlands.
authors.forename: Adri C
authors.initials: AC
authors.lastname: Voogd
authors.affiliation: Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), PO Box 19079, 3501 DB, Utrecht, The Netherlands.
authors.forename: Marieke W
authors.initials: MW
authors.lastname: Louwman
authors.affiliation: Department of Surgery, Canisius-Wilhelmina Hospital, PO Box 9015, 6500 GS, Nijmegen, The Netherlands.
authors.forename: Luc J
authors.initials: LJ
authors.lastname: Strobbe
authors.affiliation: Department of Radiology, Canisius-Wilhelmina Hospital, Weg door Jonkerbos 100, PO Box 9015, 6500 GS, Nijmegen, The Netherlands.
authors.forename: Dick
authors.initials: D
authors.lastname: Venderink
authors.affiliation: Department of Radiology, Canisius-Wilhelmina Hospital, Weg door Jonkerbos 100, PO Box 9015, 6500 GS, Nijmegen, The Netherlands. lemduijm@hotmail.com.|Dutch Reference Centre for Screening, PO Box 6873, 6503GJ, Nijmegen, The Netherlands. lemduijm@hotmail.com.
authors.forename: Lucien E M
authors.initials: LE
authors.lastname: Duijm
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods*; D012189:Retrospective Studies
keywords: Breast cancer; Early detection of cancer; Mammography; Mass screening; Referral and consultation