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Digital mammography screening: sensitivity of the programme dependent on breast density
Stefanie Weigel1, W Heindel2, J Heidrich3
1Department of Clinical Radiology and Reference Center for Mammography, University of Muenster, Albert-Schweitzer-Campus 1, Building A1, 48149, Muenster, Germany. weigels@uni-muenster.de.
European Radiology
|November 9, 2016
Summary
Breast density significantly impacts digital mammography screening sensitivity. While overall sensitivity was 79.9%, women with ACR 4 density had a 50% sensitivity, significantly lower than other categories.
Area of Science:
- Radiology and Imaging
- Oncology
- Public Health Screening
Background:
- Breast density is a known factor influencing mammography effectiveness.
- Population-based screening programs aim for high sensitivity in cancer detection.
Purpose of the Study:
- To evaluate the impact of breast density on the sensitivity of a digital mammography screening program.
- To analyze screening performance across different American College of Radiology (ACR) density categories.
Main Methods:
- Prospective analysis of 25,576 digital mammography examinations.
- Stratification by ACR density categories (1-4) with independent double reading.
- Calculation of overall sensitivity (SP) using screen-detected and interval cancers over 24 months.
Main Results:
- Overall screening program sensitivity was 79.9%.
- Sensitivity was significantly lower in ACR 4 density (50%) compared to ACR 3 (p<0.001).
- ACR 4 density was infrequent, observed in less than 7% of participants.
Conclusions:
- Independent double reading in digital mammography screening yields high overall sensitivity.
- Breast density, particularly ACR 4, significantly reduces screening sensitivity.
- Targeted strategies may be needed for women with dense breasts (ACR 4).
