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Home > Understanding Breast Cancer > Breast Cancer Research > Table 31: Digital mammography vs. film mammography for breast cancer screening

  


Table 31: Digital mammography vs. film mammography for breast cancer screening

This summary table contains detailed information about research studies. Summary tables offer an informative look at the science behind many breast cancer guidelines and recommendations. However, they should be viewed with some caution. In order to read and interpret research tables successfully, it is important to understand some key concepts. Learn how to read a research table

Introduction: Mammograms are X-ray images of the breast. The images can be captured on film or stored directly onto a computer (digital). Film and digital mammography are similar in their ability to find cancer [1-3]. Most centers now use digital mammography.

Because digital images are viewed on a computer, they can be lightened or darkened, and certain sections can be enlarged and looked at more closely. The ability to control images on a computer makes digital mammography more accurate than film mammography for some women. In general, digital mammography is better at finding breast cancer in women who [2]:

For women who do not fall in one of the above groups, film and digital mammography are similar in their ability to find breast cancer early.

Learn more about film and digital mammography.

Study measures (sensitivity and specificity)

The main goal of any cancer screening test is to correctly identify those people who have cancer (called the sensitivity of the test). When sensitivity is high, very few cases are missed. However, this means some healthy people will be misidentified as having cancer (a false positive result). For example, a sensitivity of 90 percent means that 90 percent of people tested who truly have cancer are correctly identified as having cancer.

An ideal cancer screening test would also be able to correctly identify all the people who do not have cancer as not having it (called the specificity of the test). When specificity is high, there are fewer false positive results, but more cases of true cancer are missed. For example, a specificity of 90 percent means that 90 percent of the people who are healthy are correctly identified as not having cancer.

No screening test has perfect sensitivity and perfect specificity. There is a trade-off between the two for all types of screening tests. That is, when a test gains sensitivity, it loses some specificity.

Learn more about the quality of screening tests.

Study selection criteria: Clinical trials that included at least 1,000 mammograms.

Table note: The studies below compare the sensitivity and specificity for film and digital mammography. At this time, there are no data comparing survival for women who have screening with film mammography versus those who have screening with digital mammography.

Study 

Study Population
(number of participants)
 

Sensitivity  

Specificity 

Film Mammography 

Digital Mammography 

Film Mammography 

Digital Mammography 

Randomized clinical trials 

Skaane et al. (Oslo II Study) [1]

23,929

62%NS 

77%NS 

98%SIG 

97%SIG 

Clinical trials 

Pisano et al. (DMIST) [2,3]

42,760

66%NS 

70%NS 

92%NS 

92%NS 

 

Among women younger than 50 with dense breast tissue

27%SIG 

59%SIG 

89%NS 

90%NS 

 

Among women younger than 50 with non-dense breast tissue

 NS 

NS 

 NS  

 NS 

 

Among women 50 years or older with dense breast tissue

 NS 

 NS 

 NS 

 NS 

 

Among women 50 years or older with non-dense breast tissue

 NS 

 NS 

 NS 

 NS 

Lewin et al. [4]

4,945

63%NS 

60%NS 

N/A

N/A

NS = No statistically significant difference in diagnostic accuracy between film and digital mammography

SIG = Statistically significant difference in diagnostic accuracy between film and digital mammography

N/A = Results not available

 

References 

1. Skaane P, Hofvind S, Skjennald A. Randomized trial of screen-film versus full-field digital mammography with soft-copy reading in population-based screening program: follow-up and final results of Oslo II study. Radiology. 244(3):708-17, 2007.

2. Pisano ED, Gatsonis C, Hendrick E, et al. for the Digital Mammographic Imaging Screening Trial (DMIST) Investigators Group. Diagnostic performance of digital versus film mammography for breast-cancer screening. N Engl J Med. 353(17):1773-83, 2005.

3. Pisano ED, Hendrick RE, Yaffe MJ, et al. for the Digital Mammographic Imaging Screening Trial (DMIST) Investigators Group. Diagnostic accuracy of digital versus film mammography: exploratory analysis of selected population subgroups in DMIST. Radiology. 246(2):376-83, 2008.

4. Lewin JM, Hendrick RE, D'Orsi CJ, et al. Comparison of full-field digital mammography with screen-film mammography for cancer detection: results of 4,945 paired examinations. Radiology. 218(3):873-80, 2001.

Updated 05/28/14