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4 - Advances in X-ray mammography

Published online by Cambridge University Press:  06 July 2010

By
Kenneth C. Young  and
David R. Dance
Edited by
Michael J. Michell
Michael J. Michell
Affiliation:
King's College Hospital, London
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Summary

Introduction

Worldwide over one million women are diagnosed with breast cancer every year (10% of all new cancers). Regular mammographic screening has been proven to reduce mortality from the disease, and the reduction was 24% in eight randomized control trials (RCTs) in women over the age of 50 years invited for screening. In the UK 1.9 million women are screened annually within the Breast Screening Programme (BSP) and 14 000 cancers are detected. Since 1989 the rate of breast cancer detection by screening in England has nearly doubled. This increased rate of detecting cancers is attributed to changes in mammographic technology and practice (e.g. by optimizing the optical density of analogue mammograms and moving to two-view mammography) as well as improvements in the skills of the radiologists interpreting the films. In recent years modern mammographic X-ray sets have seen a number of advances that include the greater availability of alternative filters and target materials. Along with this has come the introduction of more sophisticated automatic exposure controls that choose the appropriate kV, filter, and target material depending on breast thickness and composition. There has also been a change toward more flexible compression paddles. However, the greatest change has been the introduction of digital detectors instead of screen–film cassettes, and that is the main focus of this chapter.

Benefits of moving to digital mammography

Digital mammography offers a number of technical and clinical advantages over screen–film. Among the technical advantages are greater dynamic range and better detection efficiency.

Type
Chapter
Information
Breast Cancer , pp. 46 - 69
Publisher: Cambridge University Press
Print publication year: 2010

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