News Release

Results of major breast cancer screening trial show
some women may benefit from digital mammograms

CHAPEL HILL -- Digital mammography detected significantly (up to 28 percent) more cancers than screen film mammography in women ages 50 and younger, premenopausal and perimenopausal women, and women with dense breasts, according to results from the ACRIN Digital Mammographic Imaging Screening Trial (DMIST).

However, the American College of Radiology Imaging Network (ACRIN) trial, one of the largest breast cancer screening studies ever performed, showed no difference between digital and film mammography in detecting breast cancer for the general population of women. The results were reported today (Sept. 16) in a special online publication of the New England Journal of Medicine.

Principal investigator for the four-year study was Dr. Etta Pisano, Kenan professor of radiology and biomedical engineering at the University of North Carolina at Chapel Hill, director of the Biomedical Research Imaging Center at UNC and member of the UNC Lineberger Comprehensive Cancer Center. Pisano also is lead author of the journal article.

The trial, funded by the National Cancer Institute (NCI), was conducted by ACRIN and included researchers at 33 sites across the United States and Canada.

"The groups of women who may benefit from digital technology are those in which standard mammography has been less effective," Pisano said. "These results will give clinicians better guidance and greater choice in deciding which women would benefit most from various forms of mammography. Of particular interest, the cancers detected only by digital mammography are the types of cancers that must be detected early to save more lives through screening."

Starting in October 2001, DMIST enrolled 49,528 women at 33 sites in the United States and Canada who had no signs of breast cancer. Women in the trial were given both digital and film mammograms. Mammograms were interpreted independently by two different radiologists.

Breast cancer status of DMIST participants was determined through available breast biopsy information within 15 months of study entry or through follow-up mammography 10 months or later after study entry. 

The Center for Biostatistics at Brown Medical School developed the study’s statistical design and analyzed the results.

Dr. Bruce Hillman, network chair of ACRIN, said, "I am very proud of the accomplishments of the DMIST researchers. The DMIST team of clinicians and scientists did a truly miraculous job in completing this complex trial quickly and producing these important results. This landmark trial, along with others currently being conducted by ACRIN, will influence the appropriate care for women everywhere." 

Digital mammography takes an electronic image of the breast and stores it directly in a computer, allowing the recorded data to be enhanced, magnified or manipulated for further evaluation. The electronic image also can be printed on film. Film mammography units use film to both capture and display the image. The sensitivity of film mammography is somewhat limited in women with dense breasts, a population at higher risk for breast cancer. General Electric Medical Systems, Fuji Medical Systems, Fischer Imaging and Hologic digital mammography systems were tested in the trial.

Of these, all except for the Fuji system are already U.S. Food and Drug Administration-approved and available for clinical use in the United States.

"This digital mammography study demonstrates how new technologies are expanding our ability to detect breast cancer earlier in more women," said Dr. Andrew C. Von Eschenbach, director of the National Cancer Institute. "The study corroborates NCI’s commitment to exploring advanced technologies in a wide range of clinical applications and the critical role they can play in making cancer a manageable disease."

According to the NCI, in the United States, breast cancer is the most common non-skin cancer and the second leading cause of cancer-related death in women. An estimated 211,240 women will be diagnosed with breast cancer and an estimated 40,410 women will die of the disease in the United States in 2005.

ACRIN is a National Cancer Institute Clinical Trials Cooperative Group made up of investigators from more than 100 academic and community-based medical facilities nationwide and several international institutions.

The American College of Radiology is a national professional organization serving more than 32,000 diagnostic radiologists, radiation oncologists, interventional radiologists, nuclear medicine physicians and medical physicists, with programs focusing on the practice of radiology and delivery of comprehensive health-care services.

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Note: Pisano is at the ACRIN meeting until Sunday (Sept. 18). From Friday through Saturday, contact her via Shawn Farley, public relations manager for the American College of Radiology, at shawnf@acr.org. After Saturday, Pisano may be contacted via Dianne Shaw, director of communications at the UNC Lineberger Comprehensive Cancer Center, at dgs@med.unc.edu or, on Sunday, at (919) 929-9134 and, on Monday, (919) 966-7834.

ACRIN contact: Shawn Farley, (703) 648-8936 or shawnf@acr.org
UNC Lineberger contact: Dianne Shaw, (919) 966-7834 or dgs@med.unc.edu