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Computer-Aided Mammography Has Pros, Cons

Method catches more cancers, but requires more recalls and biopsies of women without disease

FRIDAY, Dec. 19 (HealthDay News) -- Computer-aided detection (CAD) mammography can detect breast cancers that single-read mammography might miss, but drawbacks may include false-positive findings and overtreatment of slow-growing cancers, according to an evidence report released by the ECRI Institute, a non-profit organization, in December.

The report's authors write that with CAD systems, a patient undergoes mammography and a radiologist reviews the findings. The computer system then checks the film or digital image and marks suspicious areas for the radiologist to review. The authors reviewed seven studies on CAD mammography involving more than 300,000 women.

The sensitivity of this method is an estimated 84.2 to 87.6 percent, and specificity is an estimated 88.1 percent to 88.3 percent, the report indicates. CAD will provide roughly 50 additional cancer diagnoses per 100,000 women screened. However, this benefit requires 1,090 to 1,290 additional recalls of women without breast cancer, along with 80 additional biopsies of women who don't have breast cancer, the institute notes.

"Advantages of CAD include that CAD does lead to the diagnosis of some cancers that would not have been diagnosed based upon single-read mammography alone," the authors write. But they add that "if CAD recognizes only slow-growing cancers that would not become clinically evident during the patient's lifetime, then these incremental diagnoses may actually be disadvantageous due to overtreatment. CAD is associated with false-positive findings, which are associated with patient distress, changes in attitude toward mammography and breast cancer, and increased utilization of health care visits."

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