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Published on: August 30, 2013
[Impact of digital mammography in the detection and management of microcalcifications]
M Mellado1, A M Osa, A Murillo
1Servicio de Radiología, Complejo Hospitalario de Navarra, Pamplona, Navarra, España. mmelladr@cfnavarra.es
Objective:
To determine whether the introduction of digital mammography in breast cancer screening has resulted in changes in the detection and management of microcalcifications.
Material And 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).
Statistical Analysis:
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.
Conclusion:
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.
Insights
Digital mammography improved microcalcification detection and ductal carcinoma in situ (DCIS) diagnosis. However, it increased recall rates and follow-up indications, potentially due to comparison challenges with older analog mammograms.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Microcalcifications are key indicators in breast cancer screening.
- Digital mammography offers potential advantages over analog systems.
- Assessing the impact of digital mammography on microcalcification detection is crucial.
Purpose of the Study:
- To evaluate changes in microcalcification detection and management after implementing digital mammography.
- To compare performance indicators between digital and analog mammography screening programs.
Main Methods:
- Retrospective analysis of breast cancer screening program performance indicators.
- Comparison of data from direct digital mammography (2008-2009) and analog mammography (2006-2007).
- Statistical analysis using chi-square test and measures of association.
Main Results:
- Digital mammography significantly increased recall rates (50.8‰ to 64‰).
- Rates of intermediate follow-up and invasive procedures for microcalcifications also rose.
- Detection of cancers via microcalcifications and diagnosis of ductal carcinoma in situ (DCIS) increased.
Conclusions:
- Digital mammography enhances microcalcification detection and DCIS diagnosis.
- Positive predictive value of invasive procedures for microcalcifications was maintained.
- Increased recall and follow-up rates with digital mammography may stem from comparison difficulties with prior analog images.
