Mellado M, Osa A M, Murillo A, Bermejo R, Burguete A, Pons M J, Erdozain N
Servicio de Radiología, Complejo Hospitalario de Navarra, Pamplona, Navarra, España.
Radiologia. 2013 Mar-Apr;55(2):142-7. doi: 10.1016/j.rx.2011.06.011. Epub 2011 Oct 19.
To determine whether the introduction of digital mammography in breast cancer screening has resulted in changes in the detection and management of microcalcifications.
We retrospectively studied the performance indicators of our breast cancer screening program that are related to the diagnosis of microcalcifications (rates of recall and recommendation of intermediate follow-up after screening, rate of indication of invasive procedures for microcalcifications and their positive predictive value, detection rate for microcalcifications, and number of ductal carcinomas in situ (DCIS) diagnosed). We compared the results obtained using direct digital mammography (september 2008-august 2009) with those obtained using analog mammography (September 2006-August 2007).
Chi-square test and measures of association.
We found that using digital mammography led to significant increases in the recall rate (from 50.8 to 64‰), in the rate of intermediate follow-up after screening (from 9.41 to 18.7‰), in the rate of indication for invasive procedures (from 1.88 to 3.01‰), in the cancers detected through microcalcifications (from 0.86 to 1.36‰), and in the number of DCIS diagnosed.
Direct digital mammography has improved the detection of microcalcifications, increasing the number of DCIS diagnosed without decreasing the positive predictive value of the invasive procedures indicated for microcalcifications. However, direct digital mammography has had a negative effect by increasing the recall rate and indication for short-term follow-up, possibly due to the difficulty of comparing the findings with those of earlier analog mammograms.
确定在乳腺癌筛查中引入数字化乳腺摄影是否导致微钙化的检测和管理发生变化。
我们回顾性研究了乳腺癌筛查项目中与微钙化诊断相关的性能指标（筛查后召回率和建议进行中期随访的比率、微钙化侵入性检查的指征率及其阳性预测值、微钙化的检出率以及原位导管癌（DCIS）的诊断数量）。我们将使用直接数字化乳腺摄影（2008年9月 - 2009年8月）获得的结果与使用模拟乳腺摄影（2006年9月 - 2007年8月）获得的结果进行了比较。
卡方检验和关联度量。
我们发现使用数字化乳腺摄影导致召回率显著增加（从50.8‰增至64‰）、筛查后中期随访率显著增加（从9.41‰增至18.7‰）、侵入性检查指征率显著增加（从1.88‰增至3.01‰）、通过微钙化检测出的癌症显著增加（从0.86‰增至1.36‰）以及DCIS诊断数量显著增加。
直接数字化乳腺摄影改善了微钙化的检测，增加了DCIS的诊断数量，且未降低微钙化侵入性检查的阳性预测值。然而，直接数字化乳腺摄影因增加召回率和短期随访指征产生了负面影响，这可能是由于难以将检查结果与早期模拟乳腺摄影的结果进行比较所致。
