Breast cancer screening results 5 years after introduction of digital mammography in a population-based screening program.

Contains fulltext : 80861.pdf (publisher's version ) (Closed access)PURPOSE: To compare full-field digital mammography (FFDM) using computer-aided diagnosis (CAD) with screen-film mammography (SFM) in a population-based breast cancer screening program for initial and subsequent screening examinations. MATERIALS AND METHODS: The study was approved by the regional medical ethics review board. Informed consent was not required. In a breast cancer screening facility, two of seven conventional mammography units were replaced with FFDM units. Digital mammograms were interpreted by using soft-copy reading with CAD. The same team of radiologists was involved in the double reading of FFDM and SFM images, with differences of opinion resolved in consensus. After 5 years, screening outcomes obtained with both modalities were compared for initial and subsequent screening examination findings. RESULTS: A total of 367,600 screening examinations were performed, of which 56,518 were digital. Breast cancer was detected in 1927 women (317 with FFDM). At initial screenings, the cancer detection rate was .77% with FFDM and .62% with SFM. At subsequent screenings, detection rates were .55% and .49%, respectively. Differences were not statistically significant. Recalls based on microcalcifications alone doubled with FFDM. A significant increase in the detection of ductal carcinoma in situ was found with FFDM (P < .01). The fraction of invasive cancers with microcalcifications as the only sign of malignancy increased significantly, from 8.1% to 15.8% (P < .001). Recall rates were significantly higher with FFDM in the initial round (4.4% vs 2.3%, P < .001) and in the subsequent round (1.7% vs 1.2%, P < .001). CONCLUSION: With the FFDM-CAD combination, detection performance is at least as good as that with SFM. The detection of ductal carcinoma in situ and microcalcification clusters improved with FFDM using CAD, while the recall rate increased

Use of Skin-Fold Thickness in Sri Lankan Children: Comparison of Several Prediction Equations

Objective: There are many prediction equations available in the literature for the assessment of body composition from skinfold thickness (SFT). This study aims to cross validate some of those prediction equations to determine the suitability of their use on Sri Lankan children. Methods: Height, weight and SFT of 5 different sites were measured. Total body water was assessed using the isotope dilution method (DO). Percentage Fat mass (%FM) was estimated from SFT using prediction equations described by five authors in the literature. Results: Five to 15 year old healthy, 282 Sri Lankan children were studied. The equation of Brook gave Ihe lowest bias but limits of agreement were high. Equations described by Deurenberg et al gave slightly higher bias but limits of agreement were narrowest and bias was not influence by extremes of body fat. Although prediction equations did not estimate %FM adequately, the association between %FM and SFT measures, were quite satisfactory. Conclusion: We conclude that SFT can be used effectively in the assessment of body composition in children. However, for the assessment of body composition using SFT, either prediction equations should be derived to suit the local populations or existing equations should be cross-validated to determine the suitability before its application