Computer-Aided Detection Tied to Increase in DCIS Diagnoses
But more use of CAD in mammography is also linked with more tests in those without disease
TUESDAY, April 16 (HealthDay News) -- The use of computer-aided detection (CAD) for screening mammography has increased in prevalence and is associated with increased diagnosis of ductal carcinoma in situ (DCIS), according to a study published in the April 16 issue of the Annals of Internal Medicine.
Joshua J. Fenton, M.D., M.P.H., from the University of California in Davis, and colleagues conducted a retrospective cohort study to examine the correlation between CAD use during screening mammography and the incidence of DCIS and invasive breast cancer among 163,099 women, aged 67 to 89 years, undergoing 409,459 mammograms from 2001 to 2006.
During the study period, the researchers found that the prevalence of CAD increased from 3.6 to 60.5 percent. CAD use correlated with a significantly increased incidence of DCIS (adjusted odds ratio [aOR], 1.17), but no increase in the incidence of invasive breast cancer (aOR, 1.00). Among women with invasive cancer, the likelihood of stage I to II compared with stage III to IV was increased with CAD (aOR, 1.27). CAD correlated with significantly increased odds of diagnostic mammography (aOR, 1.28), breast ultrasonography (aOR, 1.07), and breast biopsy (aOR, 1.10) among women without breast cancer.
"In conclusion, CAD use among older U.S. women having screening mammography is associated with increased diagnosis of DCIS and the diagnosis of invasive breast cancer at earlier stage," the authors write. "However, CAD use is also associated with increased diagnostic testing among women without breast cancer. The long-term effect of CAD on breast cancer stage, mortality, quality of life, and costs warrants investigation."