CAD Shown to Improve Early Breast Cancer Diagnosis

The positive predictive value (PPV) of biopsy recommendations, biopsy rate, and recall rate before and after the introduction of CAD were compared. Then, size, stage, and histology of tumors detected with and without CAD findings were evaluated.

"Early detection is essential in preventing breast cancer deaths, so as a mammography specialist, I'm always looking for tools to improve cancer detection,” said Judy Dean, M.D., lead author of the study, who runs her private practice out of Santa Barbara (CA, USA). "This study began as acceptance testing for the CAD system I purchased for my mammography practice in 2002. I scanned 50 known cancer cases and 50 normal mammograms to see how the software would perform on films from my own practice and was astounded to find that it marked 90% of the cancers. I was really surprised that a computer program could achieve that level of sensitivity, so I decided to see what effect it would have when put into day-to-day use in my practice,” said Dr. Dean.

Dr. Dean gathered data from more than 100 breast tumors, then evaluated the results to compare what kinds of tumors were found with and without CAD assistance. She discovered that by using the CAD system for every mammogram done during the study, not just screening patients, and even in patients with breast implants, prior surgery, or other findings, CAD was helpful in detecting more tumors.

During a 28-month period, 9,520 film-screen mammograms were interpreted. According to the study screening-detected cancers increased 13.3% with CAD assistance and 9.5% in diagnostic exams. The greatest impact was on ductal carcinoma in situ (DCIS), the most common type of non-invasive breast cancer in women, for which CAD increased cancer detection by 14.2%.

"Cancer detections were higher in both screening studies and symptomatic patients. This means that CAD should be used for all mammograms, not just routine screening examinations,” said Dr. Dean.

The study was published in the July 2006 issue of the American Journal of Roentgenology.