FFDM shows slightly higher detection rates for older women

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Within a routine screening program, full-field digital mammography (FFDM) with hard-copy image reading performed as well as screen-film mammography (SFM), in terms of process indicators, according to a meta-analysis in the May issue of Radiology.

Sarah Vinnicombe, MRCP, from the from the Breast Unit at St. Bartholomew's Hospital, Barts and the London NHS Trust in London, and colleagues undertook the study to compare the performance of FFDM, using hard-copy image reading, with that of SFM within a U.K. screening program (screening once every three years) for women aged 50 years or older; and conduct a meta-analysis of published findings along with U.K. data.

Between January 2006 and June 2007, a London population-based screening center performed 8,478 FFDM and 31,720 SFM screening exams, with the modality determined by the type of machine available at the screening site, according to the authors. For the meta-analysis, they used random-effects models to combine study-specific estimates, if appropriate.

Vinnicombe and colleagues reported that a total of 263 breast cancers were detected. After adjustment for age, ethnicity, area of residence, and type of referral, the researchers found that there was no evidence of differences between FFDM and SFM in terms of detection rates (0.68 vs. 0.72, respectively, per 100 screening mammograms, recall rates (3.2 vs. 3.4 percent), positive predictive value of an abnormal mammogram or characteristics of detected tumors.

However, the investigators reported that a meta-analysis of data from eight studies showed a slightly higher detection rate for FFDM, particularly at 60 years of age or younger (pooled FFDM-SFM difference: 0.11 per 100 screening mammograms), but no clear modality differences in recall rates or positive predictive values.

The authors also noted that the meta-analysis was consistent with FFDM yielding detection rates at least as high as those for SFM.