Doctors have been using screen film mammograms for years; however, a newer digital version of mammography may catch life-threatening breast cancers earlier and more accurately – without the feared risk of false-positive results from detecting insignificant breast changes. The breaking new study was released today in the journal Radiology.
In 2009, the United States Preventative Services Task Force (USPSTF) shocked the nation by changing their recommendations on traditional screen film mammograms. “To assess the balance of benefits and harms,” the organization started recommending regular biennial mammograms for women after the age of 50 instead of 40. In their new guidelines, the USPSTF cited the risks of regular screening, which include “psychological harms, unnecessary imaging tests, and false-positive diagnoses of breast cancer.” This new research on digital mammography may necessitate that these guidelines once again be reevaluated.
Traditional screen film mammography works by compressing a woman’s breast against two plates and taking an x-ray snapshot of the breast from above on a film placed below. This is like taking a picture with a 35mm camera.
Digital mammography, however, is like taking a snapshot with a digital camera. Instead of using an x-ray film, solid state detectors convert the x-rays into electrical signals that would enable the physician to see the breast in high-resolution on a computer screen. The quality is better than screen film mammography because the details stand out – especially for women who have dense breast tissue. Because the image is saved on a computer, it makes it easier to look for changes in the breast by comparing current images with past images.
To compare digital mammography with screen film mammography, the Dutch researchers reviewed data from almost two million screening mammograms between 2003 and 2007 and compared the results of screen film mammography to digital mammography. The researchers noticed that digital mammography was more sensitive for detecting cancers, with a detection rate per thousand of 6.8, instead of 5.6 with screen film mammography.
Additionally, digital mammograms more accurately detected clinically-significant tumors, which can lead to cancers. This is because digital mammography makes it easier to detect clinically-significant high-grade lesions over low-grade lesions, which are not life-threatening and could be safely left alone without unnecessarily traumatic biopsies, surgeries, or radiation.
One of the researchers, Dr. Andriana Bluekens, MD, from the National Expert and Training Centre for Breast Cancer Screening in Nijmegen, Netherlands, attributes this to digital mammography’s “enhanced depiction of microcalcifications,” which leads to “improved detection of [Ductal Carcinoma In Situ] and invasive carcinoma.”
Dr. Bluekens warns that “the follow-up period of the different digital screening programs is not sufficiently long enough to analyze mortality effect separately from that of [screen film mammography],” which necessitates the need for more long-term research on this issue.
The USPSTF concluded that there is insufficient evidence to recommend for or against digital mammography. However, this may change as the experts review newer research.
- Go to a center that specializes in breast imaging and may be able to use other imaging modalities that may be right for you.
- Ask your doctor to compare your mammogram to previous mammograms. It makes life-threatening cancerous changes easier to see. If you’re switching centers, ask your previous center for copies of your mammograms to give to your new doctor for review.
- Ask your doctor if other imaging modalities are right for you. If you have dense breasts, you may benefit from a breast ultrasound or an MRI. With an MRI, Christina Applegate, at age 36, was diagnosed with breast cancer that a mammogram missed. Her organization, Right Action for Women, provides aid to individuals who are at increased risk for breast cancer and do not have insurance or the financial flexibility to cover the high costs associated with breast screenings. Learn about three alternatives to a traditional screening mammogram.