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In terms of cancer detection, digital mammography not superior to film: researchers

by John R. Fischer, Senior Reporter | June 30, 2020
Women's Health

These findings, according to Farber, indicate that additional cancers detected may be mostly overdiagnosed or slowly progressing cancers. The practice shift from film to digital mammography also increased the false positive rate, which can cause increased short-term anxiety for affected women, she says, raising questions about proposals for the adoption of new mammography and other imaging technologies for population screening.

"This study highlights the importance of carefully considering the effect a new technology has on intermediate and long term benefits and harms," she said. "Currently, tomosynthesis (3D mammography) and other imaging technologies are proposed for adoption in population screening in many countries worldwide. The existing evidence indicates that tomosynthesis improves initial screen detection measures (cancer detection and/or recall rates); however, new research in tomosynthesis screening should focus on evaluating both the short term and the intermediate- to long-term outcomes, including effect on interval cancer rates."

A number of studies have since been conducted to assess the value of transitioning from film to digital mammography, specifically whether it results in improved health outcomes for women. One conducted in 2018 in the U.K. found digital mammography to be “substantially higher” in detecting grade 1 and 2 early-stage, invasive cancers than film, including for ductal and lobular cancers. They showed no difference in recall rates or the detection of grade 3 invasive cancers.

“Looking back at film screen mammography at the beginning of the study, we see a similar difficulty with detecting grade 3 cancers,” Dr. Rosalind Given-Wilson, a radiologist at St. Georges University Hospitals NHS Foundation Trust in London, and a co-author, told HCB News at the time. “It does not appear to have worsened with digital, but also has not improved.”

The findings for the study out of the University of Sydney were published in JNCI: Journal of the National Cancer Institute.

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