Computer-aided mammography improves tumor detection

A computer-aided detection or CAD system not only helps radiologists see more cancers in the breast, it also helps them detect smaller tumors at an earlier stage in younger women, according to study findings.

"Showing a 164 percent increase in detection of small, lump-forming cancers 1 cm or less in size and finding cancers in women, on average, more that 5 years younger is direct evidence that CAD has the potential to save lives when used in conjunction with screening mammography," said co-author Dr. Tommy E. Cupples from Palmetto Richland Memorial Hospital, Columbia, South Carolina.

The study included more than 27,200 screening mammograms done over a 3-year period. Roughly 19,400 of these tests were done with the CAD system, while 7,800 were done before the CAD system was installed.

Compared to the pre-CAD time period, the cancer detection rate increased 16.1 percent and the detection of cancers no bigger than 1.0 cm increased 164 percent with CAD, the authors report in the American Journal of Radiology.

Besides smaller cancers, the researchers note, the biggest improvements in detection were seen in invasive cancers (a 116 percent increase) and in stage I cancers (a 72 percent increase).

Breast cancer is a malignant growth that begins in the tissues of the breast. Over the course of a lifetime, one in eight women will be diagnosed with breast cancer.

There are several different types of breast cancer. Ductal carcinoma begins in the cells lining the ducts that bring milk to the nipple and accounts for more than 75% of breast cancers.

Lobular carcinoma begins in the milk-secreting glands of the breast but is otherwise fairly similar in its behavior to ductal carcinoma. Other varieties of breast cancer can arise from the skin, fat, connective tissues, and other cells present in the breast.
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"Invasive, lump forming cancers are more likely to be lethal if they aren't detected early, especially in younger women," Cupples said in a statement. "The average ages of mammography screening detected cancers in the CAD group was more than five years younger than in the pre-CAD group," he added.

"Cancers grow faster in younger women and are more likely to be overlooked in a background of dense breast tissue," Cupples added, and "CAD can help."

SOURCE: American Journal of Radiology, October 2005.