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Mammographic density and cancer detection: does digital imaging challenge our current understanding?
Dana S Al Mousa1, Claudia Mello-Thoms1, Elaine A Ryan1
1Medical Image Optimisation and Perception Group (MIOPeG), Discipline of Medical Imaging and Radiation Sciences, Faculty of Health Sciences, University of Sydney, NSW, Australia.
Academic Radiology
|August 7, 2014
Summary
Experienced radiologists show improved cancer detection on digital mammograms with increased breast density. This contrasts with film screen systems, potentially due to digital image manipulation capabilities.
Area of Science:
- Radiology
- Medical Imaging
- Breast Cancer Detection
Background:
- Mammographic density is a key factor influencing breast cancer detection.
- Digital mammography offers advanced image manipulation capabilities compared to film screen systems.
- Radiologist experience level may interact with mammographic density in cancer detection.
Purpose of the Study:
- To evaluate how breast density affects radiologist performance in digital mammography.
- To compare cancer detection rates between low and high mammographic density cases.
- To assess the influence of radiologist experience on performance in varying breast densities.
Main Methods:
- 150 digital mammograms (75 with cancer) were analyzed by 14 radiologists grouped by experience (2000 reads/year).
- Cases were classified as low or high mammographic density.
- Radiologist performance was measured using the jack-knife free-response receiver operating characteristic (JAFROC) figure of merit (FOM).
Main Results:
- Experienced radiologists (>2000 reads/year) had higher JAFROC FOM for high-density (0.76) vs. low-density (0.70) cases (P=.03).
- High density improved cancer location sensitivity for all radiologists (P=.03) and experienced ones (P=.04).
- No significant performance changes were noted for lesions outside dense tissue.
Conclusions:
- Increased mammographic density enhances digital mammogram interpretation for experienced radiologists.
- This effect may be attributed to digital image windowing/leveling capabilities.
- Findings differ from previous studies on film screen systems, highlighting digital imaging advantages.
