(SACRAMENTO, Calif.) -- A costly and widely used mammography add-on increases detection of noninvasive and early-stage invasive breast cancer but also makes more mistakes than mammography alone, researchers from UC Davis and the University of Washington have found.
Published in the April 16 issue of the Annals of Internal Medicine, the study of women enrolled in Medicare is the largest comparison of clinical outcomes of routine screening mammography with and without computer-assisted detection (CAD) -- software developed to enhance the detection of breast cancer during screening mammography.
CAD was most strongly associated in the study with higher incidence of ductal carcinoma in situ (DCIS), a non-invasive breast lesion typically referred to as "stage 0" because it does not affect surrounding tissue or mortality.
"DCIS progresses slowly, if at all," said lead author Joshua Fenton, an associate professor of family and community medicine at UC Davis and a national leader in research to improve the quality of health-care services. "Some of these early noninvasive lesions may never have come to clinical attention in women's lifetimes if CAD were not applied to their mammograms."
CAD also was associated with slightly higher rates of early-stage invasive breast cancer detection.
"There may be benefits if CAD detects early-stage invasive cancer before it progresses," said Fenton. "A longer-term study would be needed to see whether fewer women die of breast cancer on account of the technology."
The study also showed that CAD mammography was associated with increased diagnostic testing, including breast biopsy, among women who did not have breast cancer.
"This means that CAD increases the chances of being unnecessarily called back for further imaging or tests because of a false alarm, which is already a major problem without CAD," said study co-author Joann Elmore, a professor of internal med
|Contact: Karen Finney|
University of California - Davis Health System