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Full-Field Digital Versus Film-Screen Mammography: What the Science Shows

Steven Marks

*President, MedCom Consultants, Inc, Potomac, MD.
Address correspondence to: Steven Marks, MedCom Consultants Inc, 1311 Fallsmead Way, Potomac, MD 20854. Email: steven.marks52@gmail.com

Disclosure statement: Mr Marks reports having no financial or advisory relationship with any corporate, medical, or political organization doing work related to this paper or other business activity at MedCom Consultants, Inc.

ABSTRACT

Breast cancer is a leading cause of cancer in women. Despite declining mortality rates, breast cancer ranks just below lung cancer as a major cause of cancer death. Traditional screening mammography, which uses analog-film technology, has improved identification of abnormalities in breast architecture and evidence of calcification. Newer, computer-based digital equipment was developed to overcome the limitations of film mammography by improving the early detection of cancerous lesions, streamlining the processing and dissemination of images, and increasing diagnostic accuracy. However, instances of false-positive examinations and over-diagnosis remain problems with both modalities. A number of large-scale randomized clinical trials have demonstrated that digital mammography is more accurate and reliable in women below the age of 50 and possibly in those with dense breast tissue. The relative merits of these screening methods in other demographic groups, such as in premenopausal, perimenopausal, and postmenopausal women, and in those with a genetic predisposition to breast cancer, remain to be explored. The findings have helped shape the development of treatment guidelines issued by medical societies, cancer advocacy groups, and governmental bodies, and have important implications for radiologic technologists.

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