Deborah H Glueck1, Molly M Lamb, John M Lewin, Etta D Pisano. 1. Department of Preventive Medicine and Biometrics, University of Colorado at Denver and Health Sciences Center, Denver, CO 80262, USA. Deborah.glueck@uchsc.edu
Abstract
RATIONALE AND OBJECTIVES: We sought to compare the cancer detection rate and receiver operating characteristic (ROC) area under the curve of full-field digital mammography, screen-film mammography, and a combined technique that allowed diagnosis if a finding was suspicious on film mammography, on digital mammography, or both. MATERIALS AND METHODS: We used the data originally analyzed by Lewin and associates in 2002. In that trial, 6,736 paired full-field and digital mammograms were performed in 4,489 women. We used parametric and nonparametric tests to compare the area under the curve for ROC scores of film-screen only, digital mammography only, and the combined test. We used McNemar's test for paired proportions to compare the cancer detection rates. RESULTS: With the parametric test, neither the difference in the area under the curve between the film and combined nor the difference between the digital and combined ROC curves was significant at the Bonferroni-corrected 0.025 alpha level (film versus combined difference = 0.0563, P = .0712; digital versus combined difference = 0.0894, P = .0455). The nonparametric test showed that there was a significant difference between both film and combined (difference = 0.073, P = .008) and digital versus combined ROC curves (difference = 0.1164, P = .0008). The continuity-corrected McNemar's test showed a significant increase in the proportion of cancers detected by the combined modality over film (chi(2) = 7.111, df = 1, P = .0077), and over digital (chi(2) = 12.071, df = 1, P = .0005). CONCLUSION: Using two mammograms, one film and one digital, significantly increases the detection of breast cancer.
RATIONALE AND OBJECTIVES: We sought to compare the cancer detection rate and receiver operating characteristic (ROC) area under the curve of full-field digital mammography, screen-film mammography, and a combined technique that allowed diagnosis if a finding was suspicious on film mammography, on digital mammography, or both. MATERIALS AND METHODS: We used the data originally analyzed by Lewin and associates in 2002. In that trial, 6,736 paired full-field and digital mammograms were performed in 4,489 women. We used parametric and nonparametric tests to compare the area under the curve for ROC scores of film-screen only, digital mammography only, and the combined test. We used McNemar's test for paired proportions to compare the cancer detection rates. RESULTS: With the parametric test, neither the difference in the area under the curve between the film and combined nor the difference between the digital and combined ROC curves was significant at the Bonferroni-corrected 0.025 alpha level (film versus combined difference = 0.0563, P = .0712; digital versus combined difference = 0.0894, P = .0455). The nonparametric test showed that there was a significant difference between both film and combined (difference = 0.073, P = .008) and digital versus combined ROC curves (difference = 0.1164, P = .0008). The continuity-corrected McNemar's test showed a significant increase in the proportion of cancers detected by the combined modality over film (chi(2) = 7.111, df = 1, P = .0077), and over digital (chi(2) = 12.071, df = 1, P = .0005). CONCLUSION: Using two mammograms, one film and one digital, significantly increases the detection of breast cancer.
Authors: Etta D Pisano; Constantine Gatsonis; Edward Hendrick; Martin Yaffe; Janet K Baum; Suddhasatta Acharyya; Emily F Conant; Laurie L Fajardo; Lawrence Bassett; Carl D'Orsi; Roberta Jong; Murray Rebner Journal: N Engl J Med Date: 2005-09-16 Impact factor: 91.245
Authors: John M Lewin; Carl J D'Orsi; R Edward Hendrick; Lawrence J Moss; Pamela K Isaacs; Andrew Karellas; Gary R Cutter Journal: AJR Am J Roentgenol Date: 2002-09 Impact factor: 3.959
Authors: Anna N A Tosteson; Natasha K Stout; Dennis G Fryback; Suddhasatta Acharyya; Benjamin A Herman; Lucy G Hannah; Etta D Pisano Journal: Ann Intern Med Date: 2008-01-01 Impact factor: 25.391