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more articles by Carroll, William , MD  |  author's bio

We are pleased to introduce this new technology at all three Imaging Services sites: during the summer at the Convenient Care C

Digital Mammography Available Locally

By William Carroll, MD, PhD


In September 2005, the New England Journal of Medicine posted the results of a large clinical trial comparing digital and film mammography. The National Cancer Institute (NCI), which is part of the National Institutes of Health, sponsored the trial. Researchers conducted the study under the leadership of the American College of Radiology Imaging Network.


At the time the study results were published, approximately 8 percent of hospitals and imaging centers were offering digital mammography. In 2007, digital mammography became available at Cayuga Medical Center’s Convenient Care Center at Cortland, Commons Imaging, and at the Convenient Care Center at Ithaca and in the Imaging Services Department at Cayuga Medical Center, for a total of four new digital mammography units.


Who participated in the NCI study?


The study included approximately 50,000 women from 33 different locations across the country. The study participants were women with no history or current symptoms of breast cancer.


What did the study find in comparing digital to film mammography?


The results found that the image quality of digital mammography was superior when compared to film mammography for three groups. These groups are: women who are younger than 50 years of age; women who have not yet gone through menopause and women in peri-menopause, which means that their last menstrual period was within 12 months of the time of the study’s mammograms; and women of any age with dense breast tissue. These three groups make up 60-65 percent of women. For women not in these three specific categories, the study found no discernable difference between digital and film mammography.


Over three hundred women in the study were diagnosed with breast cancer. Of the breast cancers missed by film mammography and detected by digital mammography, many turned out to be invasive cancers and medium- to high-grade tumors that had not yet spread to the lymph nodes. Detecting and diagnosing tumors before they spread is very important for successful breast cancer treatment, which makes the study findings significant. And because digital mammography increases the detection rate among younger women, we are able to pick up on cancers earlier, which is important because breast cancer in younger women is often more aggressive.


Are there other advantages to digital mammography?


Yes, there are a number of other advantages to digital mammography. The files are electronic, not captured on film, which makes storage, retrieval, and transfer of the images easier and faster. Because digital images are viewed on a special computer monitor instead of a light box, radiologists can manipulate the digital images using computer enhancement to make them bigger and to increase or decrease contrast. Digital mammography is also well suited to computer-aided detection systems. The radiologists at Cayuga Medical Center and the Convenient Care Centers use computer-aided detection systems now for mammograms at all three sites, as a “second look” after we have read the mammogram. Standard mammograms typically require a very low dose of radiation; however, digital mammograms use approximately 25 percent less radiation than mammograms produced on film.


Is there any difference in the way digital and film mammograms are taken?


No, the process for capturing the images is the same. Digital mammograms require the same positioning and compression of the breast. As with film mammograms, the technologist typically takes two views of each breast for a digital screening mammogram.


Cayuga Medical Center radiologists on site at each location read mammograms as they are completed so patients can learn the results of the exam before they leave their appointments. For most women, a baseline mammogram is recommended at age 35, with mammograms taken annually beginning at age 40. Women with a family history of breast cancer should talk to their primary care doctor about special guidelines for breast cancer screening.


Dr. Carroll is board certified in radiology and serves on the medical staff at Cayuga Medical Center, where he is Director of Mammography.


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