Screen-Film Mammography and Soft-Copy Full-Field Digital Mammography: Comparison in the Patients with Microcalcifications

OBJECTIVE: We wanted to compare the ability of screen-film mammography (SFM) and soft-copy full-field digital mammography (s-FFDM) on two different monitors to detect and characterize microcalcifications. MATERIALS AND METHODS: The images of 40 patients with microcalcifications (three patients had malignant lesion and 37 patients had benign lesion), who underwent both SFM and FFDM at an interval of less than six months, were independently evaluated by three readers. Three reading sessions were undertaken for SFM and for FFDM on a mammography-dedicated review workstation (RWS, 2K x 2.5K), and for FFDM on a high-resolution PACS monitor (1.7K x 2.3K). The image quality, breast composition and the number and conspicuity of the microcalcifications were evaluated using a three-point rating method, and the mammographic assessment was classified into 4 categories (normal, benign, low concern and moderate to great concern). RESULTS: The image quality, the number and conspicuity of the microcalcifications by s-FFDM (on the RWS, PACS and both) were superior to those by SFM in 85.0%, 80.0% and 52.5% of the cases, respectively (p 0.01). The mammographic assessment category for the microcalcifications in the three reading sessions was similar. CONCLUSION: s-FFDM gives a superior image quality to SFM and it is better at evaluating microcalcifications. In addition, s-FFDM with the PACS monitor is comparable to s-FFDM with the RWS for evaluating microcalcifications.

Analysis and Comparison of Breast Density according to Age on Mammogram between Korean and Western Women

PURPOSE: To compare changes in breast parenchymal density among diverse age groups in asymptomatic Korean women with those of Western women, and to evaluate the effect of different patterns of breast parenchymal density on the sensitivity of screening mammography in Korean women. MATERIALS AND METHODS:We analyzed the distribution of breast parenchymal density among diverse age groups in 823 asymptomatic Korean women aged 30 -64 who underwent screening mammography between January and December 1998. On the basis of ACR BI-RADS breast composition, four density patterns were designated: patterns l and 2 related to fatty mammograms, and patterns 3 and 4 to dense mammograms. We compared the results with those for western women. RESULTS: In Korean women, the frequency of dense mammogram was 88.1 % (30 -34 years old), 91.1 % (35 - 39), 78.3 % (40 -44), 61.1 % (45 -49), 30.1 % (50 -54), 21.1 % (55 -59), and 7.0 % (60 -64). Korean women in their 40s thus showed a higher frequency of dense mammograms, but this frequency decreased abruptly be-tween the ages of 40 and 54. In Western women, however, there was little difference between 40 and 54-year-olds: the figures were 47.2 % (40 -44 years), 44.8 %(45 -49), and 44.4 %(50 -54). CONCLUSION: Because the frequency of their dense mammograms shows little change between Western women in their forties and in their fifties, it is clear that between these two age groups, mammographic sensitivity is only slightly different. Because the frequency of dense mammograms is much greater among Korean women in their forties than among Western women og the same age, and among Korean women this frequency decreases abruptly, it appears, however, that the mammographic sensitivity of Korean women is less among those in their forties than among those in their fifties. It is therefore thought that mammography combined with ultrasonography may increase screening sensitivity among Korean women under 50, who have a rela-tively higher incidence of breast cancer in the younger age groups than do Western women.