Breast cancer screening trial shows digital mammogram benefits

September 16, 2005

PROVIDENCE, R.I. -- A landmark breast cancer screening trial shows that digital mammography detected more cancers - up to 28 percent more - than screen film mammography in women 50 and younger, premenopausal and perimenopausal women, and women with dense breasts.

However, the trial, conducted by the American College of Radiology Imaging Network (ACRIN) in conjunction with the Center for Statistical Sciences at Brown Medical School, showed no difference between digital and film mammography in detecting breast cancer for the general population of women. The results are reported today in a special online publication of the New England Journal of Medicine and presented at ACRIN's fall meeting in Arlington, Va.

With 49,528 women enrolled at 33 clinical sites, including Rhode Island Hospital, the trial is one of the largest breast cancer screening studies ever performed. Brown's Center for Statistical Sciences developed the study's statistical design and analyzed the results.

"The data show that digital mammography is, on average, as good at detecting breast cancer as film mammography - and in some important subgroups of women, digital performs even better," said Constantine Gatsonis, network statistician for ACRIN, professor of community health and applied mathematics at Brown, and an author of the New England Journal article.

Because of its size and rigor, Gatsonis said, the study provides some of the best data gathered on the diagnostic accuracy of mammograms. "Neither film nor digital mammography is able to catch every cancer," Gatsonis said. "So this study data can be used to develop and improve mammography in the coming years. And that is good news for women's health."

The primary aim of the trial, dubbed the Digital Mammographic Imaging Screening Trial (DMIST), was to compare the diagnostic performance of digital and film mammography.

Women enrolled in the trial had no signs of breast cancer. Volunteers of all ages - the median age was 54 - took part. Each woman was given both digital and film screenings. Then they were randomized so that half had the digital exam first, the other half had the film exam first. Two different radiologists independently interpreted the mammograms.

Doctors determined participants' breast cancer status through follow-up mammography or available biopsy results. Biopsy information was available within 15 months of study entry. Mammograms were taken 10 months or later after study entry.

Barbara Schepps, M.D., oversaw DMIST at Rhode Island Hospital (RIH), a major trauma center for southeastern New England and the largest teaching hospital of Brown Medical School. The site enrolled 642 participants.

A radiologist and director of the Anne C. Pappas Center for Breast Imaging at RIH, Schepps said, "With this new information, we are going to strive to convert all our units to digital as soon as possible. While the study doesn't show that digital mammography benefits all women, it clearly makes a difference for younger women, a population that is known to be difficult to examine because they tend to have denser breasts.

"The important message is that all women get screened annually - whether with digital or conventional mammography," said Schepps, a clinical professor at Brown Medical School.

The study's principal investigator and senior author of the article, is Etta Pisano, M.D., the Kenan Professor of Radiology and Biomedical Engineering at the University of North Carolina-Chapel Hill. Pisano directs the Biomedical Research Imaging Center at the UNC and is a member of the UNC-Lineberger Comprehensive Cancer Center.

The National Cancer Institute funded DMIST. According to institute statistics, breast cancer is the most common non-skin cancer and the second leading cause of cancer-related death among women in the United States. An estimated 211,240 women will be diagnosed with breast cancer and an estimated 40,410 women will die of the disease in the United States in 2005.

At Brown's Center for Statistical Sciences, faculty, students, and staff develop bio-statistical methodology and conduct interdisciplinary research in medicine, public health and the biosciences. The Center is known for its expertise in diagnostic test evaluation and is home to the Biostatistics Center of ACRIN, a National Cancer Institute-sponsored clinical trials cooperative group made up of investigators from more than 100 academic and community-based facilities in the United States, as well as several abroad.
-end-
Founded in 1863, Rhode Island Hospital is a private, not-for-profit hospital and is the largest teaching hospital of Brown Medical School. A major trauma center for southeastern New England, the hospital is dedicated to being on the cutting edge of medicine and research. Rhode Island Hospital ranks 13th among independent hospitals which receive funding from the National Institutes of Health, with research awards of more than $27 million annually. Many of its physicians are recognized as leaders in their respective fields of cancer, cardiology, diabetes, orthopedics and minimally invasive surgery. Rhode Island Hospital is a founding member of the Lifespan health system.

Brown University

Related Breast Cancer Articles from Brightsurf:

Oncotarget: IGF2 expression in breast cancer tumors and in breast cancer cells
The Oncotarget authors propose that methylation of DVDMR represents a novel epigenetic biomarker that determines the levels of IGF2 protein expression in breast cancer.

Breast cancer: AI predicts which pre-malignant breast lesions will progress to advanced cancer
New research at Case Western Reserve University in Cleveland, Ohio, could help better determine which patients diagnosed with the pre-malignant breast cancer commonly as stage 0 are likely to progress to invasive breast cancer and therefore might benefit from additional therapy over and above surgery alone.

Partial breast irradiation effective treatment option for low-risk breast cancer
Partial breast irradiation produces similar long-term survival rates and risk for recurrence compared with whole breast irradiation for many women with low-risk, early stage breast cancer, according to new clinical data from a national clinical trial involving researchers from The Ohio State University Comprehensive Cancer Center - Arthur G.

Breast screening linked to 60 per cent lower risk of breast cancer death in first 10 years
Women who take part in breast screening have a significantly greater benefit from treatments than those who are not screened, according to a study of more than 50,000 women.

More clues revealed in link between normal breast changes and invasive breast cancer
A research team, led by investigators from Georgetown Lombardi Comprehensive Cancer Center, details how a natural and dramatic process -- changes in mammary glands to accommodate breastfeeding -- uses a molecular process believed to contribute to survival of pre-malignant breast cells.

Breast tissue tumor suppressor PTEN: A potential Achilles heel for breast cancer cells
A highly collaborative team of researchers at the Medical University of South Carolina and Ohio State University report in Nature Communications that they have identified a novel pathway for connective tissue PTEN in breast cancer cell response to radiotherapy.

Computers equal radiologists in assessing breast density and associated breast cancer risk
Automated breast-density evaluation was just as accurate in predicting women's risk of breast cancer, found and not found by mammography, as subjective evaluation done by radiologists, in a study led by researchers at UC San Francisco and Mayo Clinic.

Blood test can effectively rule out breast cancer, regardless of breast density
A new study published in PLOS ONE demonstrates that Videssa® Breast, a multi-protein biomarker blood test for breast cancer, is unaffected by breast density and can reliably rule out breast cancer in women with both dense and non-dense breast tissue.

Study shows influence of surgeons on likelihood of removal of healthy breast after breast cancer dia
Attending surgeons can have a strong influence on whether a patient undergoes contralateral prophylactic mastectomy after a diagnosis of breast cancer, according to a study published by JAMA Surgery.

Young breast cancer patients undergoing breast conserving surgery see improved prognosis
A new analysis indicates that breast cancer prognoses have improved over time in young women treated with breast conserving surgery.

Read More: Breast Cancer News and Breast Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.