CAD Helps Detect Smaller Potentially More Aggressive Breast Cancers In Younger Women

The study included 27,274 screening mammograms done over a threeyear period---19,402 were done using a computer-aided mammographydetection system (CAD); 7,872 were mammography studies done before theCAD system was installed, said Tommy E. Cupples, MD of ImageCare, LLCin Columbia, SC, and the lead author of the study. The study wasconducted at the South Carolina Comprehensive Breast Center.

"Overall, we saw a 16% increase in the cancer detection rate," said Dr.Cupples, but the increased detection rate doesn't tell the whole story,he said. "The more important question is do we find more cancersearlier, when they are smaller and most curable." CAD increased thedetection rate of small invasive cancers (those 1 cm or less) by 164%,said Dr. Cupples. "Invasive, lump forming cancers are more likely to belethal if they aren't detected early, especially in younger women," hesaid. "The average ages of mammography screening detected cancers inthe CAD group was more than five years younger than in the pre-CADgroup," Dr. Cupples said.

In the study, the radiologists reviewed each mammogram and thenactivated the CAD system. The CAD system "marked" areas on themammogram that were suspicious for cancer, then the radiologists wouldagain review the mammogram. "The CAD system we used was particularlyuseful for finding small masses," said Dr. Cupples. "Small masses aredifficult for radiologists to detect, especially in younger women withdenser breast tissue. The CAD system is an excellent addition to theradiologist's expertise," he said.

The recall rate -- the rate at which patients were called back foradditional studies or a biopsy -- was 7.71% in the pre-CAD group and8.34% in the CAD group. A recall rate of less than 10% is considered tobe acceptable, Dr. Cupples said. The biopsy rate increased from 1.37%in the pre-CAD period to 1.47% in the CAD period. "The increase in thedetection of smaller cancers more than made up for the increase in therecall and biopsy rate," Dr. Cupples said.

The study appears in the October 2005 issue of the American Journal of Roentgenology.

The American Roentgen Ray Society (ARRS) was founded in 1900 and is thefirst and oldest radiology society in the U.S. The ARRS is named afterWilhelm Roentgen who discovered the x-ray in 1895. For moreinformation, visit www.arrs.org.