Comparative effectiveness of digital versus film-screen mammography in community practice in the United States: a cohort study.
Comparative effectiveness of digital versus film-screen mammography in community practice in the United States: a cohort study.
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DOI：
10.7326/0003-4819-155-8-201110180-00005
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发表时间：
2011-10-18
影响因子：
39.2
通讯作者：
Breast Cancer Surveillance Consortium
中科院分区：
文献类型：
--
作者：
Kerlikowske K;Hubbard RA;Miglioretti DL;Geller BM;Yankaskas BC;Lehman CD;Taplin SH;Sickles EA;Breast Cancer Surveillance Consortium
在美国社区实践中，很少有研究对数字与胶片屏幕乳腺X射线摄影的比较有效性进行研究。确定数字和胶片屏幕乳腺X射线摄影的判读性能是否不同。前瞻性队列研究。乳腺癌监测联盟的乳房X线摄影设施。329261名年龄在40至79岁之间的女性接受了869286次乳房X线检查（231034次数字化; 638252次胶片屏幕）。在数字化或电影屏幕检查的12个月内诊断的浸润性癌症或导管原位癌，并计算乳腺X线摄影的灵敏度，特异性，癌症检出率和肿瘤结局。总体而言，数字和胶片屏幕乳腺X线摄影的癌症检出率和肿瘤特征相似，但每种模式的灵敏度和特异性因年龄，肿瘤特征，乳腺密度和绝经状态而异。与胶片屏幕乳腺X射线摄影相比，数字乳腺X射线摄影的灵敏度在60至69岁的女性中显著更高（89.9% vs. 83.0%; P = 0.014）和雌激素受体阴性癌症患者（78.5% vs. 65.8%; P = 0.016）; 40至49岁女性的临界值明显较高（82.4% vs. 75.6%; P = 0.071），乳房密度极高的人（83.6% vs. 68.1%; P= 0.051），绝经前或绝经期妇女（87.1% vs. 81.7%; P = 0.057）; 50 - 59岁女性的临界值显著较低（80.5% vs. 85.1%; P = 0.097）。除了40 - 49岁的女性（88.0% vs. 89.7%; P< 0.001）外，数字和胶片屏幕乳腺X线摄影的特异性在10岁之间相似。亚组分析的统计功效有限。总体而言，在接受筛查性乳房X光检查的50至79岁美国女性中，数字或胶片屏幕乳房X光检查的癌症检测相似。40至49岁的女性更有可能患有乳腺密度极高和雌激素受体阴性的肿瘤;如果为她们提供乳房X光检查，她们可能会选择接受数字乳房X光检查以优化癌症检测。美国国家癌症研究所.
Few studies have examined the comparative effectiveness of digital versus film-screen mammography in U.S. community practice. To determine whether the interpretive performance of digital and film-screen mammography differs. Prospective cohort study. Mammography facilities in the Breast Cancer Surveillance Consortium. 329 261 women aged 40 to 79 years underwent 869 286 mammograms (231 034 digital; 638 252 film-screen). Invasive cancer or ductal carcinoma in situ diagnosed within 12 months of a digital or film-screen examination and calculation of mammography sensitivity, specificity, cancer detection rates, and tumor outcomes. Overall, cancer detection rates and tumor characteristics were similar for digital and film-screen mammography, but the sensitivity and specificity of each modality varied by age, tumor characteristics, breast density, and menopausal status. Compared with film-screen mammography, the sensitivity of digital mammography was significantly higher for women aged 60 to 69 years (89.9% vs. 83.0%; P = 0.014) and those with estrogen receptor-negative cancer (78.5% vs. 65.8%; P = 0.016); borderline significantly higher for women aged 40 to 49 years (82.4% vs. 75.6%; P = 0.071), those with extremely dense breasts (83.6% vs. 68.1%; P= 0.051), and pre- or perimenopausal women (87.1% vs. 81.7%; P = 0.057); and borderline significantly lower for women aged 50 to 59 years (80.5% vs. 85.1%; P = 0.097). The specificity of digital and film-screen mammography was similar by decade of age, except for women aged 40 to 49 years (88.0% vs. 89.7%; P< 0.001). Statistical power for subgroup analyses was limited. Overall, cancer detection with digital or film-screen mammography is similar in U.S. women aged 50 to 79 years undergoing screening mammography. Women aged 40 to 49 years are more likely to have extremely dense breasts and estrogen receptor-negative tumors; if they are offered mammography screening, they may choose to undergo digital mammography to optimize cancer detection. National Cancer Institute.
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影响因子：
19.7
作者：
Roubidoux, MA;Bailey, JE;Helvie, MA
通讯作者：
Helvie, MA
影响因子：
10.3
作者：
Smith-Bindman, R;Chu, P;Kerlikowske, K
通讯作者：
Kerlikowske, K
影响因子：
39.2
作者：
Carney, PA;Miglioretti, DL;Ballard-Barbash, R
通讯作者：
Ballard-Barbash, R
影响因子：
19.7
作者：
Ichikawa, Laura E.;Barlow, William E.;Brenner, R. James
通讯作者：
Brenner, R. James
影响因子：
1.9
作者：
LANE, PW;NELDER, JA
通讯作者：
NELDER, JA