DEAR DR. GOTT: I am a 74-year-old female retired radiologic technologist due for my annual screening mammogram in another month. My only significant breast history is the presence of a tiny cyst diagnosed on one side two years ago. Last year, my screening mammogram was normal.
Which is better/more accurate for me to have — the digital mammogram or the long-used film-screen mammogram, and why? An assumption is made here that either study is performed and interpreted in the most skilled manner utilizing top-of-the-line equipment.
DEAR READER: Both methods use X-rays to produce images of the breast. With conventional mammography, information is stored on film that resembles a photograph negative. In the case of digital mammography, information is stored as a computer file. Now, the difference. While numerous “films” may be taken, they cannot be modified. With digitals, that information can be magnified, enhanced or manipulated for evaluation more easily than the information on a film. Through computers, digital images can assist surgeons and radiologists who may be in different locations; fewer follow-up procedures may be necessary for confirmation of suspicious lesions; and there is less radiation exposure.
The FDA approved digital mammography in 2000. A large clinical trial comparing digital to film mammography was published and failed to reveal differences in the detection of breast cancer in the women who participated. One interesting conclusion was that digital mammography was more accurate for pre- and peri-menopausal women and for women with dense breasts.
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