Preliminary results from a large clinical trial comparing digital to conventional film mammography are in: While both methods can detect breast cancer equally well in the general population, digital mammography is better suited for women younger than 50 years, those who are pre- or perimenopausal (i.e., have had a menstrual period within the last 12 months), and those with dense breasts—a population at higher risk for breast cancer.

Researchers provided both digital and film mammography to almost 50,000 asymptomatic women at 33 sites in the United States and Canada. While the diagnostic accuracy of the two methods in the entire population was similar, the accuracy of digital mammography was significantly higher than that of film mammography in women younger than 50 years, women with heterogeneously dense or extremely dense breasts on mammography, and pre- or perimenopausal women.

Digital mammography provides the additional advantages of easier access to and transmission, retrieval, and storage of images; it also uses a lower average dose of radiation. Issues of cost-effectiveness and effect on patient quality-of-life via a reduction in false-positive results will be assessed and reported at a later date.

Pisano ED, Gatsonis C, Hendrick E, et al. Diagnostic Performance of Digital versus Film Mammography for Breast-Cancer Screening—The results of the American College of Radiology Imaging Network (ACRIN) Digital Mammographic Imaging Screening Trial (DMIST). N Engl J Med. Published online September 16, 2005 and in print October 27, 2005.