Detection Rates Are Similar for Digital and Film Mammography

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Detection Rates Are Similar for Digital and Film Mammography

Digital mammography had better sensitivity when breast tissue was dense.

Although 70% of mammography machines in the U.S. are digital, only limited data exist on the diagnostic accuracy of digital mammography versus that of film-screen mammography. Using data from community-based practices, researchers evaluated the diagnostic performance of the two modalities in nearly 330,000 women (age range, 40–79).

No clinically meaningful differences were observed in overall cancer detection per 1000 examinations, sensitivity, or specificity. However, in subgroup analyses, the sensitivity of digital mammography was higher in older women (age, 60–69) and in women with estrogen receptor–negative tumors (90% vs. 83% and 79% vs. 66%, respectively). In addition, a trend was noted toward higher sensitivity of digital mammography among patients with dense breast tissue (84% and 68%; P=0.051).

Comment: The overall cancer detection rates were similar whether patients underwent digital or film-screen mammography. However, among certain subgroups, including women with dense breast tissue or those with estrogen receptor–negative tumors (both are more common in women younger than 50), sensitivity appears to be higher with digital mammography. Given these findings, if mammography is performed in younger women, digital mammography probably is preferable.

— Jamaluddin Moloo, MD, MPH

Published in Journal Watch General Medicine November 17, 2011

Citation(s):

Kerlikowske K et al. Comparative effectiveness of digital versus film-screen mammography in community practice in the United States: A cohort study. Ann Intern Med 2011 Oct 18; 155:493. (http://www.annals.org/content/155/8/493.full?mcom3)

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