In an attempt to improve the chances of detecting breast cancer, some high-tech companies have developed a way to computerize the information that comes from a mammogram. Several small studies failed to find an advantage for digital mammography, but NPR's Joanne Silberner reports that a new, large study shows a decided advantage for certain groups of women.


Radiologist Etta Pisano of the University of North Carolina headed the study.

Dr. ETTA PISANO (Radiologist, University of North Carolina): Digital mammography was better for women with dense breasts, women under age 50 and women who were pre- or perimenopausal.

SILBERNER: More than 40,000 volunteers had both types of mammography and were followed up about a year later. The National Cancer Institute paid $26 million for the study. Radiologist Dan Sullivan of the NCI says something scientists rarely say: The study is definitive.

Dr. DAN SULLIVAN (Radiologist, National Cancer Institute): It's finding cancers that wouldn't have been caught on the conventional mammogram. These are all cancers which--the majority of which are probably lethal, and so finding them early is going to be life-saving for the majority of these women.

SILBERNER: Overall, the accuracy of digital mammography was the same as conventional mammography. The data are being published by The New England Journal of Medicine. At a meeting this morning of the American College of Radiology where the information was presented, doctors in the audience asked why, if the overall accuracy was equal, there was such a decided advantage of digital mammography in certain groups. Sullivan says it's probably because there are several small subgroups where conventional mammograms are better, and as the digital technology improves, that advantage will disappear. One thing is clear, says Sullivan: In the identified groups, digital is definitely better. As for other women, over 50, whose breasts aren't dense...

Dr. SULLIVAN: I think there's no advantage to getting a digital mammogram and it would cost more.

SILBERNER: For example, Medicare pays $135 for digital mammography, compared with $86 for standard mammography. Doctors are already using digital mammography. Unless a woman is very carefully watching what the technician does, she probably wouldn't know the difference, says study head Etta Pisano.

Dr. PISANO: She wouldn't know unless she asked. It feels the same to the woman. She might notice that the tech can look at the images on a monitor right after she takes them. But in terms of the experience of the mammogram, we still mash the breasts.

SILBERNER: The radiation exposure is the same or a little less. About two-thirds of the women who volunteered for Pisano's study fit into one of the groups. Only about 8 percent of breast imaging centers have the equipment to do digital mammography.

Dr. PISANO: That means a lot of women won't be able to get it right away. And so I think it's an important point to make that if you can't get digital mammography, you should still get your screening mammogram the next time you're due to get a screening mammogram, because one--a mammogram is better than no mammogram.

SILBERNER: Pisano says a cost-effectiveness study should be completed in a month or two. Joanne Silberner, NPR News, Washington.

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