Lewin J M, Hendrick R E, D'Orsi C J, Isaacs P K, Moss L J, Karellas A, Sisney G A, Kuni C C, Cutter G R
Dept of Radiology, Univ of Colorado Health Sciences Ctr, CB E-030, 4200 E Ninth Ave, Denver, CO 80262, USA.
Radiology. 2001 Mar;218(3):873-80. doi: 10.1148/radiology.218.3.r01mr29873.
To prospectively compare full-field digital mammography (FFDM) with screen-film mammography (SFM) for cancer detection in a screening population.
At two institutions, 4,945 FFDM examinations were performed in women aged 40 years and older presenting for SFM. Two views of each breast were acquired with each modality. SFM and FFDM images were interpreted independently. Findings detected with either SFM or FFDM were evaluated with additional imaging and, if warranted, biopsy.
Patients in the study underwent 152 biopsies, which resulted in the diagnosis of 35 breast cancers. Twenty-two cancers were detected with SFM and 21 with FFDM. Four were interval cancers that became palpable within 1 year of screening and were considered false-negative findings with both modalities. The difference in cancer detection rate was not significant. FFDM had a significantly lower recall rate (11.5%; 568 of 4,945) than SFM (13.8%; 685 of 4,945) (P <.001, McNemar chi(2) model; P <.03, generalized estimating equations model). The positive biopsy rate for findings detected with FFDM (30%; 21 of 69) was higher than that for findings detected with SFM (19%; 22 of 114), but this difference was not significant.
No difference in cancer detection rate has yet been observed between FFDM and SFM. FFDM has so far led to fewer recalls than SFM.
前瞻性比较全视野数字乳腺摄影（FFDM）与屏-片乳腺摄影（SFM）在筛查人群中检测癌症的效果。
在两家机构中，对40岁及以上前来进行SFM检查的女性进行了4945次FFDM检查。每种检查方式均采集双侧乳腺的两个投照位。SFM和FFDM图像由不同人员独立解读。对SFM或FFDM检测出的异常发现进行额外影像学检查评估，必要时进行活检。
研究中的患者接受了152次活检，诊断出35例乳腺癌。SFM检测出22例癌症，FFDM检测出21例。有4例为间期癌，在筛查后1年内可触及，两种检查方式均将其视为假阴性结果。癌症检出率的差异无统计学意义。FFDM的召回率（11.5%；4945例中的568例）显著低于SFM（13.8%；4945例中的685例）（P<.001，McNemar卡方模型；P<.03，广义估计方程模型）。FFDM检测出异常发现的活检阳性率（30%；69例中的21例）高于SFM检测出异常发现的活检阳性率（19%；114例中的22例），但这种差异无统计学意义。
尚未观察到FFDM与SFM在癌症检出率上的差异。迄今为止，FFDM导致的召回次数少于SFM。
