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Digital Mammography Better Than Film for Detecting Breast Cancer in Women Under 50

Richard Hyer
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November 27, 2006 (Chicago) — Digital mammography is significantly better than film mammography for detecting breast cancer in premenopausal or perimenopausal women with dense breasts who are younger than 50 years, according to a new subgroup analysis of the American College of Radiology Imaging Network (ACRIN) Digital Mammographic Imaging Screening Trial (DMIST).

The analysis was presented here at the 92nd scientific assembly and annual meeting of the Radiological Society of North America (RSNA).

The finding confirms and expands on results of the original DMIST trial presented last year, according to principal investigator Etta D. Pisano, MD, vice dean for academic affairs at the University of North Carolina School of Medicine at Chapel Hill. The original DMIST analysis of 42,760 women found digital mammography to be better than film mammography for this subset, in 15 data analyses (P < .0033).

"The question we hoped to answer with this new analysis is why did we find the results we did?" Dr. Pisano told the conference. "People have been asking since the first minute that we announced results, how come there is one group where there was better performance, and yet no better performance overall?"

A total of 10 additional analyses were performed to get the current data, according to Dr. Pisano, examining patients according to breast density, age (<50, ?50 but <65, and ?65 years), and menopausal category, as defined by the original DMIST trial.

The trial, conducted at 33 sites in the United States, initially enrolled 49,528 women who did not have signs of breast cancer. The women provided background health information and underwent both digital and film mammography, each with at least 2 views of each breast. Results were interpreted by 2 different radiologists. An analysis of 42,760 women from the original study population determined breast cancer status by biopsy or follow-up examination at 1 year.