Dr. Robin Wilson: Digital Mammography- A New Era
Full field digital mammography (FFDM) is now considered a proven new technology for both screening and symptomatic breast imaging; it provides significantly better performance than conventional film / screen mammography. Tomosynthesis, a further development of FFDM, is now being evaluated as a technique for improving both screening sensitivity and specificity and for demonstrating multifocal disease more reliably. Computer aided detection (CAD) applied to FFDM has evolved into a useful adjunct in mammographic interpretation.
There is now very good evidence that FFDM represents a major advance in breast imaging, combining logistical advantages with improved clinical mammography performance, particularly in younger women and women with dense breasts.
There have been a number of recently published studies looking at the clinical efficacy of digital mammography. Initial studies showed equivalent performance but poorer specificity but more recent studies have shown better performance. The most important trial to date is the diagnostic performance of digital versus film/ screening mammography in breast cancer screening (known as the DMIST study) in which nearly 50,000 women had both FFDM and conventional mammography. This is the first direct comparative trial that has shown this level of improved performance for FFDM
The results of the two Oslo trials have also shown better performance for digital mammography compared to screen film mammography.
Full field digital mammography has now been shown to be the most effective mammography technique and should be considered as the technique of choice for both screening and the assessment of symptomatic breast problems.