What you need to know about digital vs. film mammograms

This post was authored by Brian Nash and posted to The Eye Opener on February 22nd, 2011.

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In a recent report published in the journal Radiology, the findings of a research group from Barcelona, Spain, provided women and the medical community with some key information about the use and efficacy of digital mammography. As reported in DoctorsLounge, the researchers, headed by Maria Sala, M.D., Ph.D, concluded that digital mammography had a lower false-positive rate than screen-film mammograms; however, there was “no significant difference in the cancer detection rate between the two, according to [the] study.”

If you are unfamiliar with this new technology, here’s a video presented by WellSpan HealthSource. See what they believe some of the benefits are for digital mammography.

httpv://www.youtube.com/watch?v=_TLhjsFeQDg

Here’s the statistical information regarding false-positive and detection rates between these two modalities of mammograms.

The researchers found no significant difference in the cancer detection rate between the two modalities, with the screen-film detection rate at 0.45 percent and digital at 0.43 percent. The false-positive rate for screen-film mammography was 7.6 percent but for digital mammography the rate was 5.7 percent. Digital mammography also had lower recall rates and was less likely to result in a false-positive result leading to an invasive procedure. The lower false-positive risk remained even after results were adjusted for women’s characteristics, screening program characteristics, and time trends.

Who should undergo digital mammography?

Dr. Michael Wu, of the Palo Alto Medical Foundation, has an informative post on the issue of who the best candidates are for digital versus film mammography. He gives a synopsis of the groups, as reported by The New England Journal of Medicine, who are the best candidates to undergo digital mammograms.

Those who benefited:

  • Women < 50
  • Women with dense breast tissue
  • Women who were premenopausal or perimenopausal.
  • Those who did not appear to benefit:

  • Women > 50
  • Women post-menopausal
  • Those without dense breast tissue
  • Dr. Wu’s post also addresses issues such as cost effectiveness and radiation exposure differences between the two methods of digital and film mammograms. What may be of interest to many women is that the actual technique (which I understand can be painful for many women) is the same. Perhaps further development of devices and systems will lower this problem – hopefully – in the future. Needless to say, the discomfort for 20 – 30 seconds is far outweighed by the benefits of early detection of breast cancer.

    3-D Mammogram recently approved by FDA

    It was also recently reported by PRNewswire that the FDA recently approved the first 3-D digital mammogram (tomosynthesis scans) system. Hologic, Inc., a leader in the development, manufacturing and distribution of medical devices, including medical imaging systems and the company whose system won this approval, ran a series of clinical trials using this new 3-D mammography system.

    Undoubtedly beaming with joy over having his company’s product be the first to be approved, Rob Cascella, President and CEO of Hologic, has this to say about this new medical weapon in the fight against breast cancer:

    Our Dimensions 3-D takes advantage of all of the benefits of digital mammography and quite simply makes it better with the combination of fast, high quality 3-D breast imaging. We believe tomosynthesis has the potential to change how screening and diagnostic mammography is performed, and over time will prove invaluable to the earliest possible detection of breast cancer and in the reduction of unnecessary diagnostic interventions.

    it will be very interesting to see if the recent study in Spain by Dr. Sala and his colleagues is taken further by his group or other researches to examine whether this newer 3-D technology will further change the landscape in lowering false-positive rates or – even more important – increasing the early detection rate for breast cancer.

    Some basic, highly disturbing facts about breast cancer:

    The PRNewswire release also provides the following information about breast cancer:

    One in eight American women will develop breast cancer sometime in her lifetime. In 2009, an estimated 192,370 new cases of invasive breast cancer were diagnosed among American women, as well as an estimated 62,280 additional cases of in situ breast cancer. Over 40,000 American women died from breast cancer in 2009. Only lung cancer accounts for more cancer deaths in American women. The stage at which breast cancer is detected influences a woman’s chance of survival. If detected early, the five-year survival rate is 98 percent. At this time, there is no sure way to prevent breast cancer, which is why regular mammograms starting for most women at age 40 are so important.

    This video by one of the country’s premier institutions for cancer treatment, MD Anderson Cancer Center, provides some very useful information and some excellent suggestions for undergoing a mammogram.

    httpv://www.youtube.com/watch?v=Y-GmNmPeqHQ

    Readers’ Information

    There is no doubt that many physicians, researchers and women have exceedingly superior knowledge of these techniques, systems, risks and benefits, and the like. Have any of you been involved in this research? Have you  had or do you know someone who has undergone digital mammography? What information can you share with our readers about this new technology? We invite you to share this information and spread the word by sharing this post with you friends. As we always say, being an informed patient is essential to improving your health and survival.

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