"In our study, we assessed its impact in the Medicare program," he said. The researchers compared the results when mammograms included CAD to when they did not.
When computer-aided detection was used, doctors found a greater number of early cancers known as ductal carcinoma in situ, or DCIS. "But the [overall] rate of invasive breast cancer diagnosis was no different with or without CAD," Fenton said.
However, among the women who did have invasive cancer, computer-aided detection was linked with a greater likelihood of finding the cancer while it was stage 1 or 2 compared to stage 3 or 4, they found.
"CAD was also associated with increased diagnostic testing among women who turned out not to have breast cancer," he said. These women, because breast cancer was suspected, had to be called back for additional tests, such as repeat mammograms or biopsies.
So is the new computer technology worth it? "Our study doesn't answer that question; it raises that question," Fenton said. The findings, he said, are a mix of potential good news and not so good. The additional tests that turn out to be unnecessary, because no cancer is found, are not desirable, he said.
Some of the very early cancers diagnosed in older women, he noted, may not have caused them a problem during their lifetime. But doctors can't say with certainty which ones will progress and which ones will not.
"Women should recognize that CAD comes with some potential risks," Fenton said. "It has the potential risk of a false-positive mammogram. If you are an older woman, [there is] the risk of overtreatment of noninvasive lesions."
Dr. Daniel Kopans, a professor of radiology at Harvard Medical School and senior radiologist in the breast imaging division at Massachusetts General Hospital, said the study provides additional information to doctors and women, but has some limitations. He was not involved with the study.
"The good news is the use of C
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