Department of Radiology, Catharina Hospital, PO Box 1350, 5602 ZA Eindhoven, The Netherlands.
Eur J Radiol. 2012 Sep;81(9):2189-94. doi: 10.1016/j.ejrad.2011.07.015. Epub 2011 Sep 8.
We retrospectively determined the effect of analogue two-view mammography versus single-view mammography at subsequent screens on breast cancer detection and determined financial consequences for a current digital mammography setting. Two screening radiologists reviewed the mammograms of 536 screen detected cancers (SDCs) and 171 interval cancers (ICs) with single-view mammography (medio-lateral-oblique view) at the last but one screen (SDCs) or latest screen (ICs). They determined whether two-view mammography at the last (but one) screen could have increased the cancer detection rate at that screening round. For subsequent screens, the radiologists also assessed the percentage of SDCs and ICs that had been missed at previous two-view screening mammography (SDC) or latest two-view screening (IC), respectively. Additional personnel and digital storage costs for standard two-view mammography at subsequent screening were calculated for digital screening. Two-view mammography could have facilitated earlier cancer detection in 40.9% (219/536) of SDCs and 39.8% (68/171) of ICs. For two-view screens, 24.4% of SDCs (213/871) were missed at previous two-view screening and 29.3% of ICs (110/375) were missed at the latest screen. Overall costs increase € 1.03/screen after implementation of digital two-view mammography. Standard two-view mammography at subsequent screening may modestly increase cancer detection at an earlier stage, whereas additional screening costs are limited.
我们回顾性地确定了后续双视图乳腺摄影与单视图乳腺摄影在乳腺癌检测方面的效果，并确定了当前数字乳腺摄影环境的经济后果。两位筛查放射科医生使用单视图（内外斜位）回顾了 536 例筛查发现的癌症（SDC）和 171 例间隔期癌症（IC）的乳腺 X 线照片，这些癌症出现在最后一次（但一次）筛查（SDC）或最新筛查（IC）。他们确定在最后一次（但一次）筛查时进行双视图乳腺摄影是否可以提高该轮筛查的癌症检出率。对于后续筛查，放射科医生还评估了在先前的双视图筛查乳腺 X 线摄影（SDC）或最新的双视图筛查（IC）中错过的 SDC 和 IC 的百分比。对于数字筛查，计算了后续筛查标准双视图乳腺摄影的额外人员和数字存储成本。双视图乳腺摄影可以更早地发现 40.9%（219/536）的 SDC 和 39.8%（68/171）的 IC。对于双视图筛查，24.4%的 SDC（213/871）在前两次双视图筛查中漏诊，29.3%的 IC（110/375）在最新的筛查中漏诊。实施数字双视图乳腺摄影后，每个部位的筛查成本增加 1.03 欧元。后续筛查标准双视图乳腺摄影可能会适度提高早期癌症的检出率，而额外的筛查成本有限。
