• Computer-aided Mammography: Should You Consider It?

    IMAGEBreast cancer is the second most common type of cancer in American women (skin cancer is the first). Chances of successful treatment are the greatest when the cancer is detected in its early stages. Mammography is a screening test which creates images of the breasts so a radiologist can locate suspicious areas. Mammography is not perfect, and researchers are working on ways to improve its accuracy. One type of technology to try make mammograms better is computer-aided mammography, also known as computer-aided detection (CAD).

    What Is Computer-aided Mammography?

    In traditional mammography, a radiologist reviews an x-ray of the breast to locate any suspicious areas and determine whether diagnostic testing is necessary. With CAD, the radiologist uses a computer program to help detect suspicious areas on a mammogram after she has done the initial review.

    What Does the Evidence Say?

    A study published in the New England Journal of Medicine showed that CAD may falsely suggest suspicious areas of growth in the breast, but may not substantially detect more breast cancer cases. The study reported that for every 100,000 mammograms, 2,985 more false positive mammograms will occur, and five more cancers will be detected. In another recent study published in the Journal of the National Cancer Institute, researchers concluded that the use of CAD did not improve the rate of detecting cancer.

    What Should You Do?

    Researchers are continuing to look for ways to improve the accuracy of mammography. CAD is one of the many types of breast imaging technologies available today, including ultrasound, digital mammography (which records images in computer code), and MRI.
    When scheduling your next mammogram, you may want to find out if CAD or another advanced breast imaging technology is available in your area. If it is, you and your doctor can decide if the technology is right for you. If your facility does not offer CAD, remember that the most important consideration in ensuring you have a quality mammogram is having a well-trained radiologist read the results.


    American Cancer Society http://www.cancer.org/

    National Breast Cancer Foundation http://www.nationalbreastcancer.org/


    Breast Cancer Society of Canada http://www.bcsc.ca/

    Radiology for Patients http://www.radiologyinfo.ca/


    Computer-aided detection does not improve mammogram accuracy, study suggests. Science Daily website. Available at: http://www.sciencedaily.com/releases/2011/07/110727161248.htm. Published July 27, 2011. Accessed November 7, 2011.

    Computer-aided mammography matches accuracy of double reading. Breast Cancer.org website. Available at: http://www.breastcancer.org/symptoms/testing/new%5Fresearch/20081001b.jsp. Published October 1, 2008. Accessed November 7, 2011.

    Cupples TE, Cunningham JE, Reynolds JC. Impact of computer-aided detection in a regional screening mammography program. American Journal of Radiology. 2005;185(4):944-950.

    Ellis RL, Meade AA, Mathiason MA, Willison KM, Logan-Young W. Evaluation of computer-aided detection systems in the detection of small invasive breast carcinoma. Radiology. 2007;245(1):88-94.

    Fenton J, Abraham L, Taplin S, et al. Effectiveness of computer-aided detection in community mammography practice. J Natl Cancer Inst 2011 Aug 3;103(15):1152.

    Fenton J, Taplin S, Carney P, et al. Influence of computer-aided detection on performance of screening mammography. N Engl J Med. 2007;356(14):1399-1409.

    Gur D, Sumkin JH, Rockette HE, et al. Changes in breast cancer detection and mammography recall rates after the introduction of a computer-aided detection system. J Natl Cancer Inst . 2004;96:185-190.

    Improving methods for breast cancer detection and diagnosis. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/factsheet/Detection/breast-cancer . Accessed November 1, 2005.

    Mammography for breast cancer screening. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated September 19, 2011. Accessed November 7, 2011.

    What you should know about breast cancer. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/wyntk/breast/page1 . Accessed November 1, 2005.

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