Go Digital for Mammography

Digital mammography resulted in lower recall and biopsy rates than screen film mammography, reinforcing the positive results of the technology advances, according to an evaluation of data from the Norwegian Breast Cancer Screening Program. 

Pertinent Points

- Digital mammography is superior to film mammography, according to an evaluation of the technology transition in Norway.

- The switch to digital mammography resulted in lower biopsy rates, lower recall, and improved predictive value for cancer.

The results, published in the journal Radiology, suggest that digital mammography is associated with less harm to patients and that the transition from film to digital screening lowered rates of false-positive findings, the authors concluded. The study allowed performance measures and outcomes of screen-film mammography (SFM) and full-field digital mammography (FFDM) before, during, and after the transition.

Researchers analyzed screening data for women 50 to 69 years of age who were enrolled in the screening program from 1996 to 2010. The study included an examination of the effect of the screening transition on the rate of cases, the recall rate, the rate of screen-detected cancer, and the rate of interval cancers.

"The study includes results from women screened with SFM only, with both SFM and FFDM, and with FFDM only,” said said Solveig Hofvind, PhD, from the Cancer Registry of Norway and Oslo University College, in Oslo, Norway in a news release. “These combinations make us able to compare early performance measures achieved when using digital mammography in a routine setting, in a proper way.”

The authors found the recall rate was 3.4% (47,091 of 1.4 million) for film mammography compared with 2.9% (13,130 of 446,172) for digital screenings (P < 0.001). In addition, the biopsy rate was higher among film screenings at 1.4% (19,776 of 1.4 million) compared with 1.1% (5108 of 446,172) for digital mammography (P < 0.001).

With the adoption of digital mammography, the positive predictive value of recall examinations increased from 19.3% (4,559 of 23,598) to 22.7% (681 of 2,995). The change also raised the positive predictive value of invasive procedures conducted after a screening identified a potential problem. The predictive value increased from 48.3% (4,651 of 9,623) to 57.5% (689 of 1,198), the authors reported.