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While mammography helps detect approximately 85% of all breast cancers and is currently the only exam approved by the U.S. Food and Drug Administration (FDA) to screen for breast cancer in women with no signs of the disease, mammography can miss up to 15% of breast cancers. However, a new study finds that the use of computer-aided detection (CAD) technology can significantly increase the number of cancers detected with mammography. CAD technology can help detect cancers in very early stages, when breast cancer treatment is most likely to be successful. CAD technology helps radiologists reduce interpretative errors by identifying and marking suspicious features on mammography films that may be associated with breast abnormalities. Radiologists may then more closely examine these areas to determine whether additional diagnostic testing is necessary (such as ultrasound or biopsy).
The Texas study, which was presented at the annual Radiological Society of North America (RSNA) meeting in Chicago on November 28, found that using CAD technology can increase the detection of breast cancer by approximately 20%. Among the 12,860 women in the study, 49 cancers were detected:
According to Timothy W. Freer, MD, director of Women’s Diagnostic and Breast Health Center in Plano, Texas, detecting breast cancer is difficult and often involves identifying subtle abnormalities on mammogram films. The CAD technology enhances the radiologist’s ability to detect abnormalities and to find breast cancer early. CAD can also pinpoint small clusters of microcalcifications, tiny calcium deposits that may indicate breast cancer. In the study, the eight breast cancers detected with the CAD technology were in very early stages and were easily treatable. According to R2 Technology, Inc, maker of a computer-aided detection (CAD) system called the R2 Imagechecker, for every 100,000 cancers currently detected by screening mammography, the use of their CAD system could result in an additional 20,500 breast cancers being detected each year. While CAD technology marks suspicious regions on mammograms for radiologists to review again after making their initial interpretation, not all of the marks from the CAD technology will indicate breast cancer. In the study, Dr. Freer said that only one in 450 marks was cancer. The CAD technology simply marks regions that radiologists may wish to go back to and examine more closely. While the CAD technology may help increase the detection of breast cancer, Dr. Freer said that that many smaller mammography centers will not be able to afford the costly technology. A CAD system costs approximately $200,000, in addition to the cost of a mammography system. The cost of CAD technology may also raise the price of mammograms for patients who receive the exams at large centers. In the study, the women did not have to pay to receive mammograms using the CAD technology. However, the Women’s Diagnostic and Breast Health Center in Plano,Texas typically charges $15 over the normal cost of a mammogram for additional interpretation with CAD technology.
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