Clinical use of digital mammography: the present and the prospects

Digital mammography is likely to replace the current routine breast imaging technology in the future because it offers advantages that should lead to both improved image quality and interpretation. Hopefully, this will result in earlier detection in breast screening programs and decreased mortality from the most frequently diagnosed of all cancers after skin cancer, which is far less deadly. At present, digital mammography has a limited clinical role; in the United States, it has been used for several years to localize lesions for tissue sampling using small field of view digital detectors. Once whole breast digital detectors are available, it seems clear that applying computer techniques to enhance and analyze the collected digital data will become routine. Results reported over the last decade indicate that computer-aided diagnosis can improve radiologists' observational performance, and it is likely that computer techniques to routinely enhance the decision-making ability of the average to below-average radiologist to the level of an expert will be developed. There are obstacles to these advances, but the combination of realizable technological solutions and the importance of the breast cancer problem clinically should provide sufficient where-withal and impetus to make digital mammography a clinical reality.