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PubMed1995

[Cost analysis of a mammographic screening program].

In this paper we evaluate the principal direct costs (staff, capital and maintenance equipment, supplies, hardware and software system, mail, advertising campaign) of the mammographic screening programme "Prevenzione Serena" (Torino), from the recruitment time to the diagnostic assessments of screen positive cases. On the basis of the annual situation of a screening Unit which supplies two-view mammographies, read by two radiologists, and of a 60% attendance rate and a 5% recall rate, we estimate a total annual cost of 1.4 thousand million lire (875,000$), a cost per invited woman of 38,600 lire (24$), per tested woman of 64,400 lire (40$) and per breast cancer detected of 9.2 million lire (5,750$). Staff accounts for about 60% of the total cost. We evaluate also some alternative scenarios, with different hypothesis about the useful life of the equipment, the discount rate, the attendance and the recall rate.

Aged↗

PubMed2004

International comparison of performance measures for screening mammography: can it be done?

OBJECTIVE: Published screening mammography performance measures vary across countries. An inter-national study was undertaken to assess the comparability of two performance measures: the recall rate and positive predictive value (PPV). These measures were selected because they do not require identification of all cancers in the screening population, which is not always possible. SETTING: The screening mammography programs or data registries in 25 member countries of the International Breast Cancer Screening Network (IBSN). METHODS: In 1999 an assessment form was distributed to IBSN country representatives in order to obtain information on how screening mammography was performed and what specific data related to recall rates and PPV were collected. Participating countries were then asked to provide data to allow calculation of recall rates, PPV and cancer detection rates for screening mammography by age group for women screened in the period 1997-1999. RESULTS: Twenty-two countries completed the assessment form and 14 countries provided performance data. Differences in screening mammography delivery and data collection were evident. For most countries, recall rates were higher for initial than for subsequent mammograms. There was no consistent relationship of initial to subsequent PPV, although PPV generally decreased as the recall rate increased. Recall rates decreased with increasing age, while PPV increased as age increased. CONCLUSION: Similar patterns for mammography performance measures were evident across countries.However, the development of a more standardized approach to defining and collecting data would allow more valid international comparisons, with the potential to optimize mammography performance. At present, international comparisons of performance should be made with caution due to differences in defining and collecting mammography data.

Breast Neoplasms↗

PubMed2006

Recalled pain ratings: a complex and poorly defined task.

UNLABELLED: Self-report ratings of pain intensity are ubiquitous in research and clinical practice. In addition to rating their current pain, patients are often asked to provide ratings to represent pain intensity over several days or weeks. Few data are available that provide insight into how people understand and accomplish this recall task. This study describes the results of structured interviews with 106 rheumatology patients with chronic pain about how they arrived at their ratings of pain intensity on a visual analog scale referenced to the past week. Most patients were unable to coherently articulate how they derived their ratings. Moreover, there was no consistency across patients. A variety of different strategies were identified that guided their responses. These results support the concern about the meaning and validity of retrospective recall ratings. Recall of pain, a seemingly simple task, is a deceptively more complex phenomenon. Efforts to improve the measurement of recalled pain need to be explored. Improving instructional sets, clearer specification of the dimensions of pain being targeted, avoiding use of a single item to measure pain, improved description of intended reference groups, and determining the length of time that patients are able to remember pain and limiting recall periods are reasonable methods that need to be explored. PERSPECTIVE: These results emphasize our lack of a full understanding of the meaning of the information elicited by commonly used pain recall questions. They point to the potential importance of clearly specifying what qualities of pain are sought and how the patient should summarize them over the reporting period.

Adult↗

PubMed2005

The use of batch reading to improve the performance of screening mammography.

OBJECTIVE: The objective of our study was to prove that batch reading of screening mammograms can reduce recall rates without sacrificing cancer detection. MATERIALS AND METHODS: We analyzed recall rate, cancer detection, minimal cancer detection, detection of low-stage cancer, and tumor size from consecutive screening mammography examinations from October 2001 to July 2003. The initial 7,984 mammograms were interpreted in the midst of a busy breast imaging practice. Although these studies were not read online, the interpretations were often interrupted for telephone calls, procedures, and diagnostic mammograms. The remaining 1,538 studies were interpreted after the institution of dedicated uninterrupted batch reading. RESULTS: Recall rates were 20.1% before and 16.2% after the introduction of batch reading (p < 0.001). Cancer detection rates were not significantly different: 5.6 cancers were detected per 1,000 examinations without and 7.2 were detected per 1,000 with batch reading. Prognostic factors for breast cancers diagnosed between these groups also were not significantly different. Of the screening-detected cancers diagnosed before batch reading, minimal cancers comprised 67% and low-stage cancers accounted for 76%. Of the cancers diagnosed using batch reading, 73% were minimal and 91% were low stage. The mean size of cancers, 11.7 mm without batch reading and 9.1 mm with batch reading, also showed no statistically significant difference. CONCLUSION: Our experience shows that batch reading can significantly reduce screening mammography recall rates without affecting the cancer detection rate or the proportion of cancers diagnosed with favorable prognostic indicators.

Breast Neoplasms↗

PubMed1996

Epistaxis in anticoagulated patients: educating an at-risk population.

Epistaxis is a common problem amongst anti-coagulated patients. Application of first-aid principles can control the majority of bleeds. In our sample of 60 patients attending the anticoagulant clinic, 40% were unable to think of a single measure that would be helpful in controlling a nose bleed. 6 weeks after being given first-aid advice the proportion of patients able to recall at least three first-aid principles had improved from 8% to 50%. First-aid education in this respect was well received and there was a good recall rate. Provision of advice verbally backed up by a printed sheet gave best rates of recall.

Anticoagulants↗

PubMed1999

Outcome analysis for women undergoing annual versus biennial screening mammography: a review of 24,211 examinations.

OBJECTIVE: Our goal was to determine differences in outcome measures between women undergoing annual versus biennial screening mammography. MATERIALS AND METHODS: A retrospective review of prospectively collected data on 24,211 consecutive screening mammography examinations was performed in women aged 40-79 years, all of whom had undergone previous normal screening mammography. Annual screening and biennial screening were defined as examinations performed 10-14 months and 22-26 months, respectively, after previous normal screening mammography. The rates of recall, biopsy, cancer detection, and interval cancer for annual and biennial screening cohorts were calculated, as were tumor size, lymph node status, and stage of invasive cancer. Interval cancer cases were identified by linkage with a regional tumor registry. RESULTS: Of the 4306 biennially screened women, 160 were recalled (3.7%), 45 were biopsied (1.0%), and cancer was detected in 19 (0.44%). Of the 19,905 annually screened women, 518 were recalled (2.6%), 150 were biopsied (0.75%), and cancer was detected in 71 (0.36%). Of the 3278 registry-linked biennially screened women, five had interval cancer (0.15%); of the 15,031 registry-linked annually screened women, 10 had interval cancer (0.07%). For biennial screening-detected cancer and interval invasive cancer combined, the median tumor size was 15 mm, 24% had lymph node metastasis, and 29% were stage 2 or higher. For annual screening-detected cancer, these measures were 11 mm, 14% positive nodes, and 17% stage 2+ cancer, respectively. CONCLUSION: Annual screening mammography results in lower recall rates than does biennial screening (p < .0001). Moreover, annual screening results in the detection of smaller tumors that have a more favorable prognosis (p = .04).

Adult↗

PubMed2007

Performance parameters for screening and diagnostic mammography in a community practice: are there differences between specialists and general radiologists?

OBJECTIVE: The purpose of this study was to compare the performance of general radiologists in interpretation of mammograms with that of breast imaging specialists in a high-volume community hospital-based private practice. MATERIALS AND METHODS: A retrospective observational study was conducted with data prospectively collected over a 5-year period in a community hospital-based practice in which 106,405 screening and 52,149 diagnostic mammograms were performed. The performance of three radiologists specializing in breast imaging was compared with that of six general radiologists. The following data were extracted and analyzed: recall rate, biopsy recommendation rate, and cancer detection rate. Statistical analysis was performed with a chi-square test and two-tailed calculation of p values. RESULTS: The recall rates of the specialists and generalists were nearly the same at 6.5% and 6.7%, respectively. The biopsy recommendation rate at recall from screening examinations was nearly the same for generalists and specialists (1.2% and 1.1%, respectively; p = 0.4504). This rate also was similar for diagnostic examinations (8.5% for generalists; 8.4% for specialists; p = 0.4086). The cancer detection rate in the screening setting was slightly higher for specialists than for generalists: 2.5 and 2.0 cancers per 1,000 cases, respectively (p = 0.0614). The cancer detection rate in the diagnostic setting was 24.2% higher among specialists (20.0 cancers per 1,000 cases) compared with generalists (16.1 cancers per 1,000 cases) (p = 0.0177). CONCLUSION: The only statistically significant difference between generalists and specialists was in cancer detection rate among patients undergoing diagnostic mammography. No statistically significant difference was identified between the two groups in terms of recall rate, biopsy recommendation rate, or percentage of favorable-prognosis cases of cancer detected. There was a trend toward greater cancer detection by specialists in the screening setting.

Breast Neoplasms↗

PubMed1998

The meaning of pain: cancer patients' rating and recall of pain intensity and affect.

The present study investigated the influence of an increase in present pain intensity on the rating and recall of the intensity and affective dimensions of clinical pain. Thirty-two cancer patients who reported that movement caused or exacerbated their pain rated their present pain intensity and affect before and after a session of physical therapy. Subjects also rated their usual, highest and lowest pain intensity and pain affect for the previous 3 days, and were randomly assigned to make these ratings either before or after the physical therapy session. Physical therapy increased the intensity (P < 0.01) but not the unpleasantness of the pain (P > 0.05), thus demonstrating a dissociation between pain intensity and pain affect. Beliefs about pain etiology also influenced post-therapy pain ratings. Subjects (N = 11) who believed that their pain was due to cancer, rated their post-therapy pain intensity and pain affect significantly higher than those subjects (N = 21) who did not believe their pain was due to cancer (both P < 0.05). For all subjects, recall of past pain intensity and affect was positively correlated with present levels of pain intensity and pain affect (P < 0.01). Thus, recall was assimilated to present pain levels. The results demonstrate the importance of rating both the intensity and affective dimensions of pain, and suggest that the significance of clinical pain influences pain ratings. These results also suggest that research on the rating and recall of pain, particularly the affective dimension of pain, should use actual patients who are experiencing changes in their naturally occurring pain.

Adolescent↗

PubMed2006

Single reading with computer-aided detection and double reading of screening mammograms in the United Kingdom National Breast Screening Program.

PURPOSE: To retrospectively determine if the use of a computer-aided detection (CAD) system can improve the performance of single reading of screening mammograms to match that of double reading in the United Kingdom. MATERIALS AND METHODS: Local research ethics committee approval was obtained; informed consent was not required. This study included a sample of 10 267 mammograms obtained in women aged 50 years or older who underwent routine screening at one of two breast screening centers in 1996. Mammograms that were double read in 1996 were randomly allocated to be re-read by eight different radiologists using CAD. The cancer detection and recall rates from double reading and single reading with CAD were compared. Statistical significance and confidence intervals were calculated with the McNemar test to account for the matched nature of the data. RESULTS: Single reading with CAD led to a cancer detection rate that was significantly (P = .02) higher than that achieved with double reading: 6.5% more cancers were detected by means of single reading with CAD than by means of double reading. However, the recall rate was higher for single reading with CAD than for double reading (8.6% vs 6.5%, respectively; P < .001). This was equivalent to relative increases of 15% and 32% in the cancer detection and recall rates, respectively. CONCLUSION: Single reading with CAD leads to an improved cancer detection rate and an increased recall rate.

Breast Neoplasms↗

PubMed1975

Dreams and dementia: a laboratory exploration of dream recall and dream content in chronic brain syndrome patients.

Seventeen (seven mild and ten severe) chronic brain syndrome patients were testes in the sleep laboratory for dream recall and content. The mildly organic patients had 57 per cent recall while the severely organic patients had 35 per cent recall. We also studied four aged severely organic patients. These patients showed a recall rate of 8 per cent. The difference between the recall rates in mildly and severely organic middle-aged patients was not statistically significant. The difference between the recall rates of the aged severely organic patients and either or both of the middle-aged groups was statistically significant (p smaller than .001). In addition, we found dream content differences between the mildly and severely organic middle-aged groups and between the combined group and normal young men.

Age Factors↗

PubMedDate not supplied

[The assessment of the impact of a double reading by expert readers in a mass mammographic study].

PURPOSE: To evaluate the role of double reading of screening mammograms by expert radiologists. MATERIAL AND METHODS: We analyzed the results of independent readings of a proficiency test of screening mammography (140 cases, 32 cancers) performed by four expert radiologists. Double reading was simulated by matching the four original readings in 6 possible combinations. The impact of double reading over single reading was evaluated in terms of increased sensitivity and increased recall rate. RESULTS: Of 32 carcinomas 22, 6, or 4 were identified by 4, 3, or 2 readers, respectively. Of 108 cases negative for cancer a recall for further investigations was suggested by 4, 3, 2, 1 or no reader(s) in 3, 3, 9, 14, or 79 cases, respectively. Inter-reader diagnostic repeatability was good (k = 0.65). Single readers achieved an average sensitivity of 89% (range 87.5-90.6%) and an average recall rate of 12.2% (range 7.4-16.6%). Simulated double reading achieved an average increase in sensitivity of 8.8% (range 6.2-10.95%) and an average increase of recall rate of 6.2% (range 3.8-8.3%). CONCLUSIONS: Even though the relative increase of recall rate is relevant (+53.2%), the corresponding gain in sensitivity justifies the use of double reading, which was confirmed to be worthwhile also when expert radiologists are involved. This study confirms the opportunity of adopting double reading as a routine procedure in mammographic screening.

Aged↗

PubMedDate not supplied

The first breast cancer screening program in southern Italy: preliminary results from three municipalities of the Naples Province.

AIMS AND BACKGROUND: It has been demonstrated that breast cancer screening induces a 30% reduction of specific mortality. In May 1990, we started a pilot screening program to assess the feasibility of carrying out such a program in Campania (southern Italy). Herein we report the results of the first round of the program from three municipalities (Giugliano, Mugnano and Qualiano) that lie within the local health district no. 23, close to the city of Naples. METHODS: Women between the ages of 50 and 69 years were sent a personalized letter inviting them to attend the screening test; those not responding were sent a second invitation. The screening test consisted of clinical examination followed by two-view mammography. Second-level diagnostic tools were sonography, fine needle aspiration (manual, echo-guided and stereotaxic) and surgical biopsy. RESULTS: Out of 5,732 women invited for the first round, 1,813 (31.6%) attended the screening. Attendance rate was higher among younger women. Ninety-one women were positive at the screening test and underwent further examination (recall rate, 5.0%). Among them, 19 had surgical biopsy (biopsy rate, 1.0%) that led to breast cancer diagnosis in 11 cases. The benign/malignant biopsy rate was 0.73. Detection rate was 6.07 x 1,000 screened women and varied among age categories, increasing within the 60-69 subgroup; detection rate/expected incidence ratio in the overall group was 4.5 and also increased within the older age category. Seven out of 11 cancers were at UICC stage O-I. Among 327 self-referring women, 38 were positive (recall rate, 11.6%), and 14 underwent biopsy (biopsy rate, 4.3%), which showed cancer in 7 cases (benign/malignant biopsy rate, 1.0). In addition, 2 inflammatory cancers were diagnosed without surgical biopsy. Thus 9 cancer cases were detected in this group. Self-referring women differed from responding women in that they had a higher frequency of symptoms or familiar history of cancer, and a higher educational level and awareness of preventive medicine. Clinical examination added no diagnostic advantage in the responding group but did not significantly worsen the recall rate. In the self-referring group, one case of inflammatory cancer was missed by mammography and diagnosed by clinical examination. CONCLUSION: The early results (recall rate = 5%, detection rate/expected incidence ratio = 4.5, benign/malignant biopsy rate = 0.73, advanced cancers = 36.4%) are encouraging and indicate the validity of the program. Strategies to improve attendance rate are planned.

Aged↗

PubMed2000

Potential contribution of computer-aided detection to the sensitivity of screening mammography.

PURPOSE: To determine the false-negative rate in screening mammography, the capability of computer-aided detection (CAD) to identify these missed lesions, and whether or not CAD increases the radiologists' recall rate. MATERIALS AND METHODS: All available screening mammograms that led to the detection of biopsy-proved cancer (n = 1,083) and the most recent corresponding prior mammograms (n = 427) were collected from 13 facilities. Panels of radiologists evaluated the retrospectively visible prior mammograms by means of blinded review. All mammograms were analyzed by a CAD system that marks features associated with cancer. The recall rates of 14 radiologists were prospectively measured before and after installation of the CAD system. RESULTS: At retrospective review, 67% (286 of 427) of screening mammography-detected breast cancers were visible on the prior mammograms. At independent, blinded review by panels of radiologists, 27% (115 of 427) were interpreted as warranting recall on the basis of a statistical evaluation index; and the CAD system correctly marked 77% (89 of 115) of these cases. The original attending radiologists' sensitivity was 79% (427 of [427 + 115]). There was no statistically significant increase in the radiologists' recall rate when comparing the values before (8.3%) with those after (7.6%) installation of the CAD system. CONCLUSION: The original attending radiologists had a false-negative rate of 21% (115 of [427 + 115]). CAD prompting could have potentially helped reduce this false-negative rate by 77% (89 of 115) without an increase in the recall rate.

Adult↗

PubMed1977

Eye movements and over rehearsal in wood recall.

Rates of overt rehearsal and eye movement were compared to each other, and were also compared as predictors of immediate and delayed recall, using practiced subjects who studied lists of eight simultaneously presented words. The correlation between number of eye fixations per word and number of rehearsals per word was greater in immediate than in delayed recall. Also, the number of fixations exceeded the number of overt rehearsals, especially under delayed-recall conditions. However, both overt rehearsals and eye movements were slower in delayed recall. The number of overt rehearsals and the number of fixations per word were good predictors of immediate recall, but neither was highly correlated with delayed recall. Engaging in overt rehearsal had the following effects: It slowed down eye movements, seemed to bias the subject toward a serial learning strategy, improved immediate recall, and did not reduce delayed recall. It was concluded that total looking time was the best predictor of long-term retention and that recall performance following overt rehearsal was different from recall performance following silent study.

Attention↗

PubMed1997

Should women with implants or a history of treatment for breast cancer be excluded from mammography screening programs?

OBJECTIVE: Our objective was to determine whether it is scientifically justified to require that women with implants or a history of treatment for breast cancer be screened in a diagnostic mammography setting and that they be excluded from mammography screening programs. MATERIALS AND METHODS: The recall rates for women with breast implants or a history of treatment for breast cancer who were screened in a dedicated mammography screening program were compared with those of other women in the screening program. The computerized records for the breast screening program of the Department of Radiology at our institution for January 1, 1990, through December 31, 1995, were reviewed. The recall rates for women who had breast implants and those for women with a history of treatment for breast cancer were compared with the recall rates for the other women who underwent screening. Each recall rate included women who were called back for additional evaluation in addition to those for whom a biopsy was recommended on the basis of the screening study. RESULTS: Of 45,134 screening examinations done during the review period, 43,454 (96%) were for women who had no history of breast cancer or of breast implants; 590 (1%) were for women who had undergone mastectomy; 991 (2%) were for women who had been treated with lumpectomy and irradiation for breast cancer; and 99 (0.2%) were for women with breast implants. Among the 43,454 examinations of women with no history of breast cancer or implants, 3081 examinations (7%) led to interpretations that produced requests for the patient to return for additional evaluation. Thirty-six women who had been treated for breast cancer by mastectomy were recalled (6%). Seventy-five women who had undergone lumpectomy and irradiation for breast cancer were recalled (8%). Five women with breast implants were recalled (5%). Statistically, these rates were not significantly different. CONCLUSION: We find no scientific reason to exclude women who have been treated for breast cancer or who have breast implants from dedicated screening programs.

Breast Implants↗

PubMed2002

Performance parameters for screening and diagnostic mammography: specialist and general radiologists.

PURPOSE: To evaluate performance parameters for radiologists in a practice of breast imaging specialists and general diagnostic radiologists who interpret a large series of consecutive screening and diagnostic mammographic studies. MATERIALS AND METHODS: Data (ie, patient age; family history of breast cancer; availability of previous mammograms for comparison; and abnormal interpretation, cancer detection, and stage 0-I cancer detection rates) were derived from review of mammographic studies obtained from January 1997 through August 2001. The breast imaging specialists have substantially more initial training in mammography and at least six times more continuing education in mammography, and they interpret 10 times more mammographic studies per year than the general radiologists. Differences between specialist and general radiologist performances at both screening and diagnostic examinations were assessed for significance by using Student t and chi(2) tests. RESULTS: The study involved 47,798 screening and 13,286 diagnostic mammographic examinations. Abnormal interpretation rates for screening mammography (ie, recall rate) were 4.9% for specialists and 7.1% for generalists (P <.001); and for diagnostic mammography (ie, recommended biopsy rate), 15.8% and 9.9%, respectively (P <.001). Cancer detection rates at screening mammography were 6.0 cancer cases per 1,000 examinations for specialists and 3.4 per 1,000 for generalists (P =.007); and at diagnostic mammography, 59.0 per 1,000 and 36.6 per 1,000, respectively (P <.001). Stage 0-I cancer detection rates at screening mammography were 5.3 cancer cases per 1,000 examinations for specialists and 3.0 per 1,000 for generalists (P =.012); and at diagnostic mammography, 43.9 per 1,000 and 27.0 per 1,000, respectively (P <.001). CONCLUSION: Specialist radiologists detect more cancers and more early-stage cancers, recommend more biopsies, and have lower recall rates than general radiologists.

Biopsy↗

PubMed2005

Comparing the performance of mammography screening in the USA and the UK.

To compare the performance of screening mammography in the USA and the UK, a consecutive sample of screening mammograms was obtained in women aged 50 and older from 1996 to 1999 who participated in the Breast Cancer Surveillance Consortium in the USA (n = 978,591) and the National Health Service Breast Cancer Screening Program in the UK (n = 3.94 million), including 6943 diagnosed with breast cancer within 12 months of screening. Recall rates were defined as the percentage of screening mammograms with a recommendation for further evaluation including diagnostic mammography, ultrasound, clinical examination or biopsy, and cancer detection rates including invasive cancer and ductal carcinoma in situ diagnosed within 12 months of a screening mammogram. All results were stratified by whether examinations were first or subsequent and adjusted to a standard age distribution. Among women who underwent a first screening mammogram, 13.3% of women in the USA versus 7.2% of women in the UK were recalled for further evaluation (relative risk for recall 1.9; 95% CI 1.8-1.9). For subsequent examinations recall rates were approximately 50% lower, but remained twice as high in the USA as in the UK. A similar percentage of women underwent biopsy in each setting, but rates of percutaneous biopsy were lower and rates of open surgical biopsy were higher in the USA. Women undergo screening approximately every 18 months in the USA and every 36 months in the UK. Based on a 20-year period of screening, the estimated percentage of women who would be recalled for additional testing was nearly threefold higher in the USA. The number of cancers detected was also higher in the USA (55 versus 43), and most of the increase was in the detection of small invasive and in situ cancers. The numbers of large cancers detected ( > 2 cm) were very similar between the two countries. Recall rates are approximately two to three times higher in the USA than in the UK. Importantly, despite less frequent screening in the USA, there are no substantial differences in the rates of detection of large cancers. Efforts to improve mammographic screening in the USA should target lowering the recall rate without reducing the cancer detection rate.

Aged↗

PubMed2003

Population-based mammography screening: comparison of screen-film and full-field digital mammography with soft-copy reading--Oslo I study.

PURPOSE: To compare screen-film and full-field digital mammography with soft-copy reading in a population-based screening program. MATERIALS AND METHODS: Full-field digital and screen-film mammography were performed in 3,683 women aged 50-69 years. Two standard views of each breast were acquired with each modality. Images underwent independent double reading with use of a five-point rating scale for probability of cancer. Recall rates and positive predictive values were calculated. Cancer detection rates determined with both modalities were compared by using the McNemar test for paired proportions. Retrospective side-by-side analysis for conspicuity of cancers was performed by an external independent radiologist group with experience in both modalities. RESULTS: In 3,683 cases, 31 cancers were detected. Screen-film mammography depicted 28 (0.76%) malignancies, and full-field digital mammography depicted 23 (0.62%) malignancies. The difference between cancer detection rates was not significant (P =.23). The recall rate for full-field digital mammography (4.6%; 168 of 3,683 cases) was slightly higher than that for screen-film mammography (3.5%; 128 of 3,683 cases). The positive predictive value based on needle biopsy results was 46% for screen-film mammography and 39% for full-field digital mammography. Side-by-side image comparison for cancer conspicuity led to classification of 19 cancers as equal for probability of malignancy, six cancers as slightly better demonstrated at screen-film mammography, and six cancers as slightly better demonstrated at full-field digital mammography. CONCLUSION: There was no statistically significant difference in cancer detection rate between screen-film and full-field digital mammography. Cancer conspicuity was equal with both modalities. Full-field digital mammography with soft-copy reading is comparable to screen-film mammography in population-based screening.

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