Technology evaluation center assessment synopsis: full-field digital mammography

Area of Science:

• Radiology
• Medical Imaging
• Oncology

Background:

• Screen-film mammography (SFM) is the traditional standard for breast cancer screening.
• Full-field digital mammography (FFDM) offers potential advantages in image optimization and radiation dose.
• Assessing the comparative accuracy of FFDM and SFM is crucial for clinical practice.

Purpose of the Study:

• To systematically review the evidence comparing FFDM and SFM for breast cancer detection.
• To evaluate the accuracy of FFDM versus SFM in both screening and diagnostic mammography.
• To determine the efficacy of FFDM in specific patient subgroups, including younger women and those with dense breasts.

Main Methods:

• Systematic review incorporating data from the ACR Imaging Network(R) Digital Mammographic Imaging Screening Trial (DMIST).
• Analysis of results from 42,760 asymptomatic women undergoing both FFDM and SFM.
• Review of available studies on digital mammography versus film mammography in diagnostic settings.

Main Results:

• No significant difference in accuracy between FFDM and SFM for asymptomatic women overall.
• FFDM demonstrated advantages in certain subgroups, particularly for detecting invasive carcinomas or higher-grade ductal carcinoma in situ.
• Limited new studies specifically addressed FFDM versus SFM in a diagnostic population.

Conclusions:

• FFDM is as accurate as SFM for general screening of asymptomatic women.
• Evidence supports the use of FFDM for diagnostic mammography, especially given its potential to detect more significant cancers.
• FFDM may offer benefits for younger women and those with denser breast tissue.