Computer-aided Mammography: Should You Consider It?
Breast cancer is the second most common type of cancer in American women (skin cancer is the first). Chances of successful treatment are the greatest when the cancer is detected in its early stages. Mammography is a screening test which creates images of the breasts so a radiologist can locate suspicious areas. Mammography is not perfect, and researchers are working on ways to improve its accuracy. One type of technology to try make mammograms better is computer-aided mammography, also known as computer-aided detection (CAD).
Computer-aided Mammography
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 displayed on a computer monitor, where suspicious areas are highlighted by a computer program for review by a radiologist.
The Evidence on Computer-aided Mammography
In 2007, the New England Journal of Medicine, published a study that showed computer-aided mammography may falsely suggest suspicious areas of growth in the breast (false positive), but may not substantially detect more breast cancer cases. The study reported that for every 100,000 mammograms, 2,985 more false positive mammograms will occur, and five more cancers will be detected.
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 sensitive as conventional mammography. One of the main drawbacks of computer-aided mammography is that it is expensive.
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.
RESOURCES:
American Cancer Society
http://www.cancer.org
National Cancer Institute
http://www.cancer.gov
References:
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.
Mammography for breast cancer screening. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated November 21, 2009. Accessed November 23, 2009.
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 2009 by Brian Randall, MD
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