The Latest in Breast Cancer Screening: Computer-Aided Mammography
Finding breast cancer before symptoms develop is important, since the chances of successful treatment are the greatest when the cancer is detected in its early stages. The most effective breast cancer screening tool available today is mammography , which creates images of the breasts so a radiologist can locate suspicious areas. While mammography is a valuable screening tool, it is not perfect, and researchers are working on ways to improve its accuracy. One promising technology is computer-aided mammography, also known as computer-aided detection (CAD).
In traditional mammography, a radiologist reviews an x-ray of the breast to locate any suspicious areas and determine whether diagnostic testing is necessary. In computer-aided mammography, the radiologist uses a computer program to help detect suspicious areas on a mammogram after he or she has performed the initial review.
The Food and Drug Administration first approved a computer-aided mammography device in 1998. In this technique, the mammogram x-ray is scanned by a laser beam and converted to a digital signal that can be processed by a computer. The mammogram image is displayed on a computer monitor, where suspicious areas are highlighted for review by a radiologist.
The Benefits of Computer-Aided Mammography
Computer-aided mammography can highlight suspicious areas that may be missed when a radiologist visually reviews a conventional mammogram. And recent research indicates that computer-aided mammography may be able to detect smaller tumors at an earlier stage.
A study in the October 2005 issue of the American Journal of Radiology evaluated the results of more than 27,000 screening mammograms, approximately 19,400 of which were performed with a computer-aided system. Compared with conventional mammography, computer-aided mammography detected 16% more cancers overall, 164% more small tumors (1.0 centimeters or smaller), 116% more invasive cancers (cancers that have spread outside the milk duct), and 72% more early-stage cancers (stage I).
But not all studies show a clear benefit with computer-aided mammography. Another large study published in the February 4, 2005 issue of the Journal of the National Cancer Institute compared the results of 114,571 mammograms, roughly half of which were computer-aided and the other half were traditional. In that study, there were no differences in cancer detection rates between computer-aided and traditional mammography.
Who Should Consider Computer-Aided Mammography?
Researchers are continuing to look for ways to improve the accuracy of mammography. Computer-aided mammography is one of the many types of breast imaging technologies available today, including ultrasound , digital mammography (which records images in computer code), and magnetic resonance imaging (MRI) .
Since the radiologist always reviews the conventional mammogram before using the computer-aided technique, computer-aided mammography is theoretically at least as effective as conventional mammography—and it appears it may even be more effective. The main drawback of computer-aided mammography is that it is expensive. It costs hundreds of thousands of dollars for a healthcare facility to purchase a computer-aided mammography system, and approximately $15 more per mammogram than conventional mammography.
When scheduling your next mammogram, find out if computer-aided mammography or other advanced breast imaging technologies are available to you. If they are, you and your healthcare provider can decide if the technology is right for you. If your facility does not offer computer-aided mammography, remember that the most important consideration in ensuring you have a quality mammogram is having a well-trained, experienced health professional interpret it.
American Cancer Society
National Cancer Institute
Cupples TE, Cunningham JE, Reynolds JC. Impact of computer-aided detection in a regional screening mammography program. American Journal of Radiology . 2005;185(4):944-950.
Gur D, Sumkin JH, Rockette HE, et al. Changes in breast cancer detection and mammography recall rates after the introduction of a computer-aided detection system. J Natl Cancer Inst . 2004;96:185-190.
Improving methods for breast cancer detection and diagnosis. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/factsheet/Detection/breast-cancer . Accessed November 1, 2005.
What you should know about breast cancer. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/wyntk/breast/page1 . Accessed November 1, 2005.
Last reviewed November 2005 by Jill Landis, MD
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