Nicholas Mark Perry MD, Abstract Co-Author: Nothing to Disclose

Snehal M. Pinto Pereira MSc, Abstract Co-Author: Nothing to Disclose

Valerie A. McCormack MSc, Abstract Co-Author: Nothing to Disclose

Sarah Jane Vinnicombe MD, Presenter: Nothing to Disclose

Susan Shiel, Abstract Co-Author: Nothing to Disclose

Isabel Im dos Santos Silva MD, PhD, Abstract Co-Author: Nothing to Disclose

To compare the performance of full-field digital mammography with hard-copy reading (FFDM) with that of conventional screen-film mammography (SFM) within the context of a national 3-yearly, 2-view mammography screening program for women aged 50+ yrs.

The Central and East London Breast Screening Service was the first centre in the UK National Heath Service Breast Screening Program to incorporate FFDM into routine screening. 30 438 women were screened in 2005-6; 6251 (20.5%) underwent FFDM (with 3 GE Senographe DS units and 1 Lorad Selenia) and the remaining SFM (with Lorad M IV). Allocation to modality was mainly by residential area. All mammograms were double-read. Logistic regression was used in the analyses.

214 breast cancers were detected. After adjustment for age, ethnicity, residential area and type of referral, there was no statistically significant difference in the cancer detection rate between FFDM and SFM at ages 50-60 (6.5 [95% CI 3.9, 10.7] vs. 5.9 [4.3, 8.2] per 1000 women, respectively; P=0.72) or at older ages (8.0 [4.8, 13.5] vs. 8.6 [6.4, 11.5] per 1000 women, respectively; P=0.80). There was also no significant difference in the recall rate between FFDM and SFM at ages 50-60 (2.4% [2.7%, 4.0%] vs. 3.3% [2.9%, 3.8%], respectively; P=0.94) or at older ages (3.4% [2.7%, 4.3%] vs. 3.1% [2.7% vs. 3.5%], respectively; P=0.48). The adjusted positive predictive value (PPV) of an abnormal mammographic finding was similar for FFDM and SFM at ages 50-60 (19.2% [12.0%, 29.4%] vs. 18.1% [13.3%, 24.2%], respectively; P=0.81) and at older ages (22.6% [13.8%, 34.7%] vs. 27.8% [21.6% vs. 35.0%], respectively; P=0.41). There was no association between type of cancer (invasive/in situ) and imaging modality, but FFDM detected larger invasive tumors at ages 50-60 (P=0.03).

Initial evaluation has shown that FFDM with hard-copy reading and conventional SFM have similar recall rates, cancer detection rates, and PPV in a screening program for women aged 50+. FFDM detects larger invasive tumors at ages 50-60.

In the context of a population-based screening setting for women aged 50+ the performance of FFDM with hard-copy reading is comparable to that of conventional SFM.

Perry, N, Pinto Pereira, S, McCormack, V, Vinnicombe, S, Shiel, S, dos Santos Silva, I, Comparison of Full-field Digital Mammography with Conventional Screen-film Mammography within a Population-based Breast Screening Program in the UK.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5004153.html