van Bommel Rob, Voogd Adri C, Louwman Marieke W, Strobbe Luc J, Venderink Dick, Duijm Lucien E M
Department of Radiology, Catharina Hospital, PO Box 1530, 5602 ZA, Eindhoven, The Netherlands.
Department of Epidemiology, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands.
Eur Radiol. 2017 Feb;27(2):553-561. doi: 10.1007/s00330-016-4399-y. Epub 2016 May 14.
The aim of this study was to retrospectively determine screening outcome in women recalled twice for the same mammographic lesion before, during, and after transition from screen-film (SFM) to full-field digital screening mammography (FFDM).
We included women with a repeated recall for the same mammographic abnormality (37 at subsequent SFM-screening, obtained between January 2000-April 2010; respectively 54 and 65 women with a prior SFM-screen or FFDM-screen followed by subsequent FFDM-screening, obtained between May 2009-July 2013).
At SFM-screening, repeated recalls for the same lesion comprised 1.2 % of recalls (37/3217), including 13 malignancies (positive predictive value (PPV), 35.1 %). During the SFM to FFDM transition (SFM-screen followed by FFDM-screen), FFDM recalls comprised more repeated recalls for the same lesion (2.2 %, P = 0.002), with a lower PPV (14.8 %, P = 0.02). This proportion increased to 2.8 % after transition to FFDM (i.e., two successive FFDM-screens), with 16 malignancies (PPV, 24.6 %). Invasive cancers at repeated recall were smaller than interval cancers (T1a-c, 79.4 versus 46.8 %, P = 0.001), with less lymph node involvement (20.6 versus 46.5 %, P = 0.007).
More women are repeatedly recalled for the same mammographic abnormality during and after the transition from SFM to FFDM-screening, with comparable cancer risks before and after the transition. These cancers show better prognostic characteristics than interval cancers.
• FFDM-screening increases the number of repeated recalls for the same mammographic abnormality. • The PPV of these recalls is comparable before and after transition to FFDM-screening. • Cancers diagnosed after a repeated recall are smaller than interval cancers. • These cancers also show less lymph node involvement than interval cancers.
本研究旨在回顾性确定在从屏-片乳腺摄影（SFM）过渡到全视野数字化乳腺筛查摄影（FFDM）之前、期间和之后，因同一乳腺摄影病变被召回两次的女性的筛查结果。
我们纳入了因同一乳腺摄影异常被重复召回的女性（2000年1月至2010年4月期间后续SFM筛查中有37例；2009年5月至2013年7月期间，分别有54例和65例之前接受过SFM筛查或FFDM筛查，随后进行FFDM筛查）。
在SFM筛查中，因同一病变的重复召回占召回总数的1.2%（37/3217），包括13例恶性肿瘤（阳性预测值（PPV）为35.1%）。在从SFM过渡到FFDM期间（先进行SFM筛查，随后进行FFDM筛查），FFDM召回中因同一病变的重复召回更多（2.2%，P = 0.002），PPV较低（14.8%，P = 0.02）。过渡到FFDM后（即连续两次FFDM筛查），这一比例增至2.8%，有16例恶性肿瘤（PPV为24.6%）。重复召回时的浸润性癌比间期癌小（T1a - c期，分别为79.4%和46.8%，P = 0.001），淋巴结受累情况较少（分别为20.6%和46.5%，P = 0.007）。
从SFM过渡到FFDM筛查期间及之后，更多女性因同一乳腺摄影异常被重复召回，过渡前后癌症风险相当。这些癌症的预后特征优于间期癌。
• FFDM筛查增加了因同一乳腺摄影异常的重复召回次数。• 过渡到FFDM筛查前后，这些召回的PPV相当。• 重复召回后诊断出的癌症比间期癌小。• 这些癌症的淋巴结受累情况也比间期癌少。
