Original Title: Application 37

Authors' results and conclusions: Safety - The literature identified in the systematic review suggests that the radiation exposure from digital mammography (DM) is equivalent to that from film-screen mammography (FM). However, phantom studies of more recent mammography units suggest that the radiation dose from DM is likely to be lower than that from FM. It can therefore be concluded that DM is as safe as, or safer than, FM in regards to radiation dose. Effectiveness - As a potential replacement for FM, DM is as accurate when used as a screening method in asymptomatic women. The case for replacing FM is not obvious overall, given the similar accuracy and cancer detection rates of the two methods. DM would, however, appear to be a reasonable alternative to FM on the basis of the population-based effectiveness data alone. In contrast, DM is more accurate in detecting breast cancer in women who are conventionally difficult to image with FM, specifically women aged under 50 years, those who are pre- or perimenopausal, and those with heterogeneously dense or extremely dense breasts. Thus DM should replace or be used in addition to FM in these women (although the latter increases the cumulative radiation risk). If DM replaces FM for screening asymptomatic women who are aged under 50 years, pre- or perimenopausal, or have dense breasts, it is likely that the mortality reduction would be higher than currently seen in these subgroups. For the diagnosis of women at potentially high risk or symptomatic women, it is unclear whether DM is as effective as FM. Although no significant differences in the diagnostic properties of the two methods have been reported in the literature, it is difficult to make any strong conclusions on the available evidence. There is currently no evidence to suggest that DM should be used in addition to FM in a symptomatic or surveillance population.

Project Status: Completed

Year Published: 2008

URL for published report: Not Available

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Australia

Organisation Name: Adelaide Health Technology Assessment

Contact Address: School of Public Health, Mail Drop 545, University of Adelaide, Adelaide SA 5005, AUSTRALIA, Tel: +61 8 8313 4617

Contact Name: ahta@adelaide.edu.au

Contact Email: ahta@adelaide.edu.au

Copyright: Adelaide Health Technology Assessment (AHTA)