Screen-Film Mammography versus Full-Field Digital Mammography with Soft-Copy Reading: Randomized Trial in a Population-based Screening Program—The Oslo II Study

TLDR: FFDM allowed a higher cancer detection rate than did SFM in the group aged 50-69, although the difference did not reach statistical significance, and SFM and FFDM with soft-copy reading are comparable techniques for population-based screening mammography programs.

Abstract: PURPOSE: To prospectively compare cancer detection rates, recall rates, and positive predictive values at screen-film mammography (SFM) with those at full-field digital mammography (FFDM) with soft-copy reading in a population-based screening program in Norway. MATERIALS AND METHODS: Of 43,429 women invited, 25,263 women aged 45–69 years attended the screening program and were randomized, with adjustments for age and area of residence, to undergo SFM or FFDM. Two standard views of each breast were acquired. Independent double reading was performed with use of a five-point rating scale for probability of cancer. Recall rates, positive predictive values, and cancer detection rates were compared for two age groups (45–49 and 50–69 years) by using the χ2 test. RESULTS: Overall, 73 cancers in 17,911 women were detected at SFM (detection rate, 0.41%), compared with 41 cancers in 6,997 women at FFDM (detection rate, 0.59%; P = .06). In the group aged 50–69 years, 56 cancers in 10,304 women were detected at SFM (...