Differences in radiological patterns, tumour characteristics and diagnostic precision between digital mammography and screen-film mammography in four breast cancer screening programmes in Spain


Por: Domingo, L, Romero, A, Belvis, F, Sanchez, M, Ferrer, J, Salas, D, Ibanez, J, Vega, A, Ferrer, F, Laso, M, Macia, F, Castells, X and Sala, M

Fecha de Publicación: 01/09/2011
Resumen:
Objectives To compare tumour characteristics between cancers detected with screen-film mammography (SFM) and digital mammography (DM) and to evaluate changes in positive predictive values (PPVs) for further assessments, for invasive procedures and for distinct radiological patterns in recalled women. Methods 242,838 screening mammograms (171,191 SFM and 71,647 DM) from 103,613 women aged 45-69 years, performed in four population-based breast cancer screening programmes in Spain, were included. The tumour characteristics and PPVs of each group were compared. Radiological patterns (masses, calcifications, distortions and asymmetries) among recalled women were described and PPVs were evaluated. Results The percentages of ductal carcinoma in situ (DCIS) were higher in DM than in SFM both in the first [18.5% vs. 15.8%(p = 0.580)] and in successive screenings [23.2% vs. 15.7%(p = 0.115)]. PPVs for masses, asymmetries and calcifications were higher in DM, being statistically significant in masses (5.3% vs. 3.9%; proportion ratio: 1.37 95%CI: 1.08-1.72). Among cancers detected by calcifications, the percentage of DCIS was higher in DM (60.3% vs. 46.4%, p = 0.060). Conclusions PPVs were higher when DM was used, both for further assessments and for invasive procedures, with similar cancer detection rates and no statistically significant differences in tumour characteristics. The greatest improvements in PPVs were found for masses.

Direcciones
Domingo, L: IMIM Hosp del Mar, Dept Epidemiol & Evaluat, Barcelona 08003, Spain; CIBERESP, Barcelona, Spain; Univ Autonoma Barcelona, EHEA Doctoral Program Publ Hlth, Dept Pediat Obstet & Gynecol Prevent Med & Publ H, E-08193 Barcelona, Spain
Romero, A: IMIM Hosp del Mar, Dept Epidemiol & Evaluat, Barcelona 08003, Spain; CIBERESP, Barcelona, Spain
Belvis, F: IMIM Hosp del Mar, Dept Epidemiol & Evaluat, Barcelona 08003, Spain; CIBERESP, Barcelona, Spain
Sanchez, M: Govt Cantabria, Dept Hlth, Gen Directorate Publ Hlth, Santander 39009, Spain
Ferrer, J: Hosp Santa Caterina, Radiol Unit, Girona 17190, Spain; Hosp del Mar, Radiol & Nucl Med Serv, Barcelona 08003, Spain
Salas, D: DIRECCIÓN GENERAL DE SALUD PÚBLICA, Valencia, Spain; CENTRO SUPERIOR DE INVESTIGACIÓN EN SALUD PÚBLICA (CSISP), Valencia, Spain
Ibanez, J: DIRECCIÓN GENERAL DE SALUD PÚBLICA, Valencia, Spain; CENTRO SUPERIOR DE INVESTIGACIÓN EN SALUD PÚBLICA (CSISP), Valencia, Spain
Vega, A: Hosp Univ Marques de Valdecilla, Radiol Unit, Santander 39008, Spain
Laso, MS: Breast Canc Screening Unit Burjassot Valencia, Valencia, Spain; CENTRO SUPERIOR DE INVESTIGACIÓN EN SALUD PÚBLICA (CSISP), Valencia, Spain
Macia, F: IMIM Hosp del Mar, Dept Epidemiol & Evaluat, Barcelona 08003, Spain; CIBERESP, Barcelona, Spain
Castells, X: IMIM Hosp del Mar, Dept Epidemiol & Evaluat, Barcelona 08003, Spain; CIBERESP, Barcelona, Spain
Sala, M: IMIM Hosp del Mar, Dept Epidemiol & Evaluat, Barcelona 08003, Spain; CIBERESP, Barcelona, Spain; Univ Autonoma Barcelona, EHEA Doctoral Program Publ Hlth, Dept Pediat Obstet & Gynecol Prevent Med & Publ H, E-08193 Barcelona, Spain
ISSN: 09387994





EUROPEAN RADIOLOGY
Editorial
SPRINGER, 233 SPRING ST, NEW YORK, NY 10013 USA, Alemania
Tipo de documento: Article
Volumen: 21 Número: 9
Páginas: 2020-2028s
WOS: 000293640500027
ID de PubMed: 21560024

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