News: The better to see you with: Improving screening for breast Ca

While film mammography remains the gold standard for breast cancer screening, new mammographic techniques and modalities are promising to improve sensitivity and specificity, according to findings presented by investigators at the Scientific Sessions of the Radiological Society of North America (RSNA) held in November 2007 in Chicago.

Creating the greatest buzz was digital tomosynthesis. While mammography takes two x-ray images of a compressed breast–– one from bottom to top and one from side to side, this new technology takes multiple x-ray images over an arc around the breast. The images are then converted by a computer to 3-dimensional pictures that can be viewed as a movie or as 1-mm slices. The technology should prove particularly useful in women with dense breasts and could reduce the 8% callback rate associated with traditional mammography by 37%. That's about 2 million women per year who could avoid further worry and testing. The radiation dose is comparable to that of mammography.

Other advances include digital mammography, which produces an electronic image that can be stored and transmitted by computer. It is slightly more sensitive than its film counterpart in women under age 50 years, in those who are premenopausal, and in women with dense breasts. Computer-aided detection, which serves as a second read for radiologists, may also improve sensitivity and specificity of traditional mammography. Stereoscopic digital mammography, which uses two digital x-ray images acquired from two different viewpoints separated by about 8°, provides a 3D view of the internal structure of the breast.

Mitka M. New screening methods offer hope for more accurate breast cancer detection. JAMA. 2008;299:397-398.