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Full-field digital mammography compared to screen film mammography in the prevalent round of a population-based screening programme: the Vestfold County Study
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Breast
Full-field digital mammography compared to screen film mammography in the prevalent round of a population-based screening
programme: the Vestfold County Study
Einar Vigeland1  , Herman Klaasen2 , Tor Audun Klingen3 , Solveig Hofvind4 and Per Skaane5
| (1) |
Department of Radiology, Vestfold Hospital, Halfdan Wilhelmsens Alle 17, 3116 Tønsberg, Norway |
| (2) |
Department of Radiology, Aberdeen Royal Infirmary, Foresterhill AB25 2ZN, Aberdeen, Scotland, UK |
| (3) |
Department of Pathology, Vestfold Hospital, Halfdan Wilhelmsens Alle 17, 3116 Tønsberg, Norway |
| (4) |
The Cancer Registry of Norway, Fritjof Nansens vei 17, 0369 Oslo, Norway |
| (5) |
Department of Radiology, Ullevaal University Hospital, Kirkeveien 166, NO-0407 Oslo, Norway |
Received: 3 February 2007 Revised: 24 May 2007 Accepted: 12 July 2007 Published online: 7 August 2007
Abstract The purpose of the study was to compare the performance of full-field digital mammography (FFDM) with soft-copy reading to
screen film mammography (SFM) used during the first prevalent 2-year round of population-based screening. A total of 18,239
women aged 50–69 years were screened with FFDM as part of the Norwegian Breast Cancer Screening Programme (NBCSP). Process
indicators were compared to data from 324,763 women screened with SFM using the common national database of the NBCSP. The
cancer detection rates were 0.77% (140/18,239) for FFDM and 0.65% (2,105/324,763) for SFM (p = 0.058). For ductal carcinoma
in situ (DCIS) alone, the results were: FFDM 0.21% (38/18,239) compared to SFM 0.11% (343/324,763) (p < 0.001). Recall rates
due to positive mammography were for FFDM 4.09% (746/18,239), while for SFM 4.16% (13,520/324,764) (p = 0.645), due to technically
insufficient imaging: FFDM 0.22% (40/18,239) versus SFM 0.61% (1,993/324,763) (p < 0.001). The positive predictive value (PPV)
in the FFDM group was 16.6% (140/843), while 13.5% (2,105/15,537) for SFM (p = 0.014). No statistically significant differences
were recorded concerning histological morphology, tumour size, or lymph node involvement. In conclusion FFDM had a significantly
higher detection rate for DCIS than SFM. For invasive cancers no difference was seen. FFDM also had a significantly higher
PPV and a significantly lower technical recall rate.
Keywords Breast cancer - Mammography - Mass screening
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