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Promising Developments in Digital Mammography
As stated earlier, preliminary results of the Digital Mammographic Screening Trial (DMIST), released in September 2005, show that digital mammography may be more accurate at detecting breast cancer in some women than standard film mammography. According to the study results, digital and standard film mammography had similar accuracy rates for many women. However, digital mammography was significantly better at screening women in any of the following categories:
- under age 50, regardless of what level of breast tissue density they had
- of any age with very dense or extremely dense breasts
- pre- or perimenopausal women of any age (defined as women who had a last menstrual period within 12 months of their mammograms)
The study showed no benefit for post-menopausal women over age 50 who did not have dense breast tissue.
The FDA approved the first
"full-field" digital mammography scanner to screen for and diagnose breast
cancer in February 2000. Before applying for FDA certification, data was gathered from 662
patients at four institutions: the University of Colorado, the University of Massachusetts
Medical Center, Massachusetts General Hospital, and the Hospital of the University of
Pennsylvania. The data compared hard copies of digital breast images on film to
conventional mammography films finding that digital mammography is as effective at
detecting breast cancer as standard film mammograms. A separate study revealed that the
digital mammography scanner showed a slight advantage in the visibility of breast tissue
at the skin line.
Disadvantages
to Digital Mammography
While digital mammography is quite
promising, it still has additional hurdles to undergo before it replaces conventional
mammography. Digital mammography must:
- provide higher detail resolution (as
standard mammography does)
- become less expensive (digital mammography is currently several
times more costly than conventional mammography)
- provide a method to efficiently compare
digital mammogram images with existing mammography films on computer monitors
Standard mammography using film
cassettes has the benefit of providing very high detail resolution (image sharpness),
which is especially useful for imaging microcalcifications (tiny calcium deposits) and
very small abnormalities that may indicate early breast cancer. While full-field digital
mammography may lack the spatial resolution of film, clinical
trials have shown digital mammography to be at least equivalent to standard film
screening mammography. This is because digital mammography has the benefit of providing
improved contrast resolution, which may make abnormalities easier to see. Various
manufacturers are trying to develop digital mammography systems with detail resolution
equivalent to standard film mammography while also providing the benefits of digital
mammography noted above.
The high cost of digital mammography is
a major obstacle. Digital mammography systems costs roughly 1.5 to 4 times as much as
standard mammography equipment. Standard mammography systems are currently installed in
over 10,000 locations across the United States. It may take years for this current
equipment to be updated or replaced and for digital mammography to become widespread.
Additional Resources and References
Updated: May 4, 2008
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