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While mammography helps detect approximately 85% of all breast
cancers and is currently the only exam approved by the U.S. Food and Drug Administration
(FDA) to screen for breast cancer in women with no signs of the disease, mammography can
miss up to 15% of breast cancers. However, a new study finds that the use of computer-aided detection (CAD) technology can significantly increase
the number of cancers detected with mammography. CAD technology can help detect cancers in
very early stages, when breast cancer treatment is most
likely to be successful.
CAD technology helps radiologists reduce interpretative errors by identifying and
marking suspicious features on mammography films that may be associated with breast
abnormalities. Radiologists may then more closely examine these areas to determine whether
additional diagnostic testing is necessary (such as ultrasound
or biopsy).
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The CAD system marks suspicious areas on the digitized mammogram film. Photo
courtesy of R2 Technology, Inc., maker of a computer-aided detection (CAD) system called
the R2 Imagechecker. |
The Texas study, which was presented at the annual Radiological Society of North
America (RSNA) meeting in Chicago on November 28, found that using CAD technology can
increase the detection of breast cancer by approximately 20%. Among the 12,860 women in
the study, 49 cancers were detected:
- 32 cancers were detected by both CAD technology and by the radiologist, who interpreted
the women’s regular mammogram films
- nine cancers were detected by the radiologist alone
- eight cancers were detected by the CAD technology alone (the radiologist then reviewed
the mammogram films again to find the suspicious areas)
According to Timothy W. Freer, MD, director of Women’s Diagnostic and Breast
Health Center in Plano, Texas, detecting breast cancer is difficult and often involves
identifying subtle abnormalities on mammogram films. The CAD technology enhances the
radiologist’s ability to detect abnormalities and to find breast cancer early. CAD
can also pinpoint small clusters of microcalcifications,
tiny calcium deposits that may indicate breast cancer. In the study, the eight breast
cancers detected with the CAD technology were in very early stages and were easily
treatable.
According to R2 Technology, Inc, maker of a computer-aided detection (CAD) system
called the R2 Imagechecker, for every 100,000 cancers currently detected by screening
mammography, the use of their CAD system could result in an additional 20,500 breast
cancers being detected each year.
While CAD technology marks suspicious regions on mammograms for radiologists to review
again after making their initial interpretation, not all of the marks from the CAD
technology will indicate breast cancer. In the study, Dr. Freer said that only one in 450
marks was cancer. The CAD technology simply marks regions that radiologists may wish to go
back to and examine more closely.
While the CAD technology may help increase the detection of breast cancer, Dr. Freer
said that that many smaller mammography centers will not be able to afford the costly
technology. A CAD system costs approximately $200,000, in addition to the cost of a
mammography system. The cost of CAD technology may also raise the price of mammograms for
patients who receive the exams at large centers. In the study, the women did not have to
pay to receive mammograms using the CAD technology. However, the Women’s Diagnostic
and Breast Health Center in Plano,Texas typically charges $15 over the normal cost of a
mammogram for additional interpretation with CAD technology.
Additional Resources and References
- The study, "Computer-Aided Detection (CAD) in Screening Mammography: A Prospective
Study of 12,860 Patients in a Community Breast Center," was presented by Timothy W.
Freer, MD, director of the Women’s Diagnostic and Breast Health Center in Plano,
Texas.
- To learn more about the computer-aided detection (CAD) mammography system made by R2
Technology, please visit http://www.imaginis.com/breasthealth/cad.asp
- To learn more about mammography, please visit http://www.imaginis.com/breasthealth/mammography.asp
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