Digital mammography, a technique which uses slightly less radiation, takes an electronic image of the breast and stores it directly in a computer. The digital mammogram image can be manipulated, interpreted, stored, and transmitted—all electronically. Doctors can access computerized test results, all part of a digital medical record, and patients never retrieve and deliver films.
Another difference—perhaps the largest drawback of digital mammography—is cost. Digital mammography systems cost up to four times more than film systems. Medicare and some private insurers may cover digital mammography. Even so, the impact of the high cost of the diagnostic technology can be felt at the patient level. In my case, the difference was two-fold. My last conventional mammogram cost $120. My digital mammogram cost $228.
Digital mammography has its advantages—but not for everyone. In some cases, conventional mammography performs as well or better.
In 2005, results of the Digital Mammographic Imaging Screening Trial (DMIST) were announced and women with dense breasts, women younger than 50, and pre- and perimenopausal women were told they could benefit from digital mammograms. Results, however, showed no difference in detecting breast cancer for the general population of women.
Sponsored by the National Cancer Institute (NCI), DMIST enrolled nearly 50,000 women with no signs of breast cancer at 33 sites in the United States and Canada to determine how digital and film mammography compare. Previous trials showed no difference, due to small numbers of participants and limited access to digital equipment. DMIST, correcting for these limitations, found small but clinically significant differences between the two processes. Essentially, digital mammography was deemed life-saving for some women.
The bottom line: Digital mammography is available in about 19 percent of breast imaging centers, as of April 2, 2007: Out of about 8,800 facilities certified to perform mammography, about 1,700 facilities have digital mammography systems. And it is at least as important as film mammography for most women. It’s even better—and recommended—for a specific group of women, namely those with elevated breast cancer risk.
To determine if digital mammography is right for you, talk with your physician—who can also help you locate screening facilities. Also ask your doctor if you might benefit from breast ultrasound and MRI screening.
Don’t forget the tried and true recommendations for prevention and early detection of breast cancer—conduct self-examinations every month, report for yearly physical exams, and receive mammograms annually beginning at age 40.
