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Differences in radiological patterns, tumour characteristics and diagnostic precision between digital mammography and screen-film mammography in four breast cancer screening programmes in Spain

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Abstract

Objectives

To compare tumour characteristics between cancers detected with screen-film mammography (SFM) and digital mammography (DM) and to evaluate changes in positive predictive values (PPVs) for further assessments, for invasive procedures and for distinct radiological patterns in recalled women.

Methods

242,838 screening mammograms (171,191 SFM and 71,647 DM) from 103,613 women aged 45–69 years, performed in four population-based breast cancer screening programmes in Spain, were included. The tumour characteristics and PPVs of each group were compared. Radiological patterns (masses, calcifications, distortions and asymmetries) among recalled women were described and PPVs were evaluated.

Results

The percentages of ductal carcinoma in situ (DCIS) were higher in DM than in SFM both in the first [18.5% vs. 15.8%(p = 0.580)] and in successive screenings [23.2% vs. 15.7%(p = 0.115)]. PPVs for masses, asymmetries and calcifications were higher in DM, being statistically significant in masses (5.3% vs. 3.9%; proportion ratio: 1.37 95%CI: 1.08–1.72). Among cancers detected by calcifications, the percentage of DCIS was higher in DM (60.3% vs. 46.4%, p = 0.060).

Conclusions

PPVs were higher when DM was used, both for further assessments and for invasive procedures, with similar cancer detection rates and no statistically significant differences in tumour characteristics. The greatest improvements in PPVs were found for masses.

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Acknowledgments

We are grateful to Sonia Sánchez, Paula Merino, and Cristina Hernández for their contribution in the data collection of the screening programs, as well as to Jordi Blanch and Rubén Román for their assistance in analysis and data management. This study was supported by grants from Instituto de Salud Carlos III FEDER (PI07/90293).

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Authors and Affiliations

  1. Department of Epidemiology and Evaluation, IMIM-Hospital del Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain

    Laia Domingo, Anabel Romero, Francesc Belvis, Francesc Macià, Xavier Castells & Maria Sala

  2. CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain

    Laia Domingo, Anabel Romero, Francesc Belvis, Francesc Macià, Xavier Castells & Maria Sala

  3. EHEA Doctoral Program in Public Health. Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Universitat Autònoma de Barcelona (UAB), Bellaterra, Barcelona, Spain

    Laia Domingo & Maria Sala

  4. General Directorate of Public Health. Department of Health, Government of Cantabria, C/ Federico Vial, 13, 39009, Santander, Spain

    Mar Sánchez

  5. Radiology Unit. Hospital Santa Caterina, C/ Doctor Castany s/n, 17190, Girona, Spain

    Joana Ferrer

  6. General Directorate Public Health & Centre for Public Health Research (CSISP), Avd. Catalunya, 21, 46002, Valencia, Spain

    Dolores Salas & Josefa Ibáñez

  7. Radiology Unit, Hospital Universitario Marqués de Valdecilla, Avda. Valdecilla, 25, 39008, Santander, Spain

    Alfonso Vega

  8. Radiology and Nuclear Medicine Service, Hospital del Mar, Passeig Marítim, 08003, Barcelona, Spain

    Francesc Ferrer

  9. Breast Cancer Screening Unit Burjassot.Valencia (Spain) & Centre for Public Health Research (CSISP), C/ Sixto Cámara, 12. 46100 Burjasot, Valencia, Spain

    M. Soledad Laso

Authors
  1. Laia Domingo
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  2. Anabel Romero
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  3. Francesc Belvis
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  4. Mar Sánchez
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  5. Joana Ferrer
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  6. Dolores Salas
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  7. Josefa Ibáñez
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  8. Alfonso Vega
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  9. Francesc Ferrer
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  10. M. Soledad Laso
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  11. Francesc Macià
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  12. Xavier Castells
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  13. Maria Sala
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Corresponding author

Correspondence to Maria Sala.

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Domingo, L., Romero, A., Belvis, F. et al. Differences in radiological patterns, tumour characteristics and diagnostic precision between digital mammography and screen-film mammography in four breast cancer screening programmes in Spain. Eur Radiol 21, 2020–2028 (2011). https://doi.org/10.1007/s00330-011-2143-1

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  • DOI: https://doi.org/10.1007/s00330-011-2143-1

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