Conspicuity of breast cancer according to histopathological type and breast density when imaged by full-field digital mammography compared with screen-film mammography.

OBJECTIVES: To compare the conspicuity of different histopathological types of breast cancer according to breast density and mammographic imaging in patients with screen-detected breast cancers undergoing both full-field digital mammography (FFDM) and screen-film mammography (SFM) in the United Kingdom National Health Service Breast Screening Programme (NHSBSP).
METHODS: 185 patients underwent routine screening with SFM followed by further imaging using FFDM with consequent diagnosis of breast cancer. All SFM and soft-copy FFDM images were evaluated by two readers in an independent, retrospective review. The visualisation and conspicuity of the mammographic abnormality were recorded and graded using a four-level scale. Conspicuity of breast cancer was qualitatively evaluated. Breast density and conspicuity were correlated with histopathological diagnosis and inter-observer correlation was calculated.
RESULTS: Mixed Model ANOVA demonstrated significant differences between FFDM and SFM (p<0.001) and breast densities (p=0.009): conspicuity of the mammographic abnormality (p<0.001) and visualisation of the dominant mammographic feature (p<0.001) were significantly greater with FFDM than SFM. This held true for both readers and for all histopathological tumour types with no significant differences between each tumour type.
CONCLUSION: FFDM is significantly superior to SFM for conspicuity of screen-detected breast cancers for all histopathological types and breast densities.