Quick Scan Review (with the permission of Johns Hopkins University School of Medicine)
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Quick Scan Review (with the permission of Johns Hopkins University School of Medicine)
Editing and Translation by Perikles Vassilopoulos
Digital Mammography More Accurate in Certain Patients for Cancer Detection Take-Home Pearl: Women with very dense breasts have improved cancer detection rates with digital mammography compared to film screen mammography. Article Reviewed: Kerlikowske K, Hubbard RA, et al. Comparative Effectiveness of Digital Versus Film-Screen Mammography in Community Practice in the United States. A Cohort Study. Ann Intern Med 2011; 155 (October 18): 493-502. Objective: To determine if digital mammography is supe¬rior to film-screen mammography in women. Design: Prospective cohort study. Participants: 329.261 women aged 40 to 79 years who underwent mammograms. . Methods: Data from 4 mammography registries were pooled and linked to population-based cancer data registries. Mammography sensitivity, specificity, cancer detection rates, and tumor outcomes were compared with respect to digital and film-screen mammography. Results: Overall digital and film-screen mammography yielded similar cancer detection rates and proportions of early-stage cancers diagnosed. Digital screening had higher sensitivity in women with verydense breasts and was better at detecting estrogen receptor negative cancer, but was lower for women aged 40 to 49 years than for other decades. Conclusions: Screening methods for digital and film-screen mammography are similarly effective, but sensitivity and specificity tradeoffs occur in some subgroups. Women aged 40 to 49 years are more likely to have extremely dense breasts and estrogen receptor-negative tumors; therefore digital mam-
Dr. Perikles Vassilopoulos is professor and Chairman of Surgery in Ongology at Anticancer Hospital “Agios Savas”, Athens, Greece
mography may be more appropriate to optimize cancer detection in this population. Reviewer’s Comments: These data utilize popula¬tion-based cancer registries to ascertain whether digital or film-screen mammography provides supe¬rior screening ability. Previous studies have yielded conflicting results in terms of the superiority of one modality compared to the other. Through this large population base some of the pitfalls of previous studies have been overcome due to small sample size. These results help to define the subpopulation most likely to benefit from digital mammography. Specifically women with very dense breasts and estrogen-negative tumors have higher detection with digital mammography. Since younger women fall into these categories more frequently digital mammog¬raphy should be considered in this population. Reviewer: Raminder Nirula, MD, FACS
«Σε γυναίκες με πυκνό παρέγχυμα των μαστών τους η ψηφιακή μαστογραφία πλεονεκτεί της κλασσικής στην ανίχνευση καρκινικών αλλοιώσεων» Αντικείμενο της μελέτης και σχεδιασμός: Να προσδιορίσει εάν η ψηφιακή μαστογραφία πλεονεκτεί της κλασσικής. Σχεδιασμός της μελέτης και συμμετοχή των γυναικών: Πρόκειται για προοπτική συγκριτική ανάλυση (cohort) σε σύνολο 329.261 γυναικών η
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