Computer-Aided Detection Reduces the Accuracy of Mammograms

by Barbara Kram, Editor | April 09, 2007

Seven facilities, representing 16 percent of the study sites, implemented computer-aided detection during the study period. With the use of CAD, 32 percent more women were recalled for more tests and 20 percent more women had a breast biopsy. Use of the software had no clear impact on the early detection of breast cancer. The study suggests that, if anything, the software may promote the detection of the least dangerous breast cancers, such as localized, in situ breast cancers. The effect of in situ cancers on breast cancer mortality remains unknown and some evidence suggests that not all develop into serious cancers.

Every time the CAD software marks a real cancer, a radiologist has to consider about 2,000 additional false-positive marks, making it very difficult to distinguish between real cancers and those that are not cancer. The authors estimate that for every additional woman diagnosed with breast cancer on the basis of CAD, 156 women are falsely recalled for more tests and 14 had unnecessary biopsies to exclude cancer.

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"It's unfortunate that the use of the software has proliferated so widely before we are certain of its benefits," said Fenton. "We need studies to determine if the benefits of the software outweigh its harms and costs. There is also the potential for new studies to improve the performance of CAD software."

The authors estimate that if all mammography facilities adopt CAD, the annual cost of mammograms in the United States could increase 18 percent, or an additional $550 million nationwide.

For a Q&A on this finding, please go to http://www.cancer.gov/newscenter/pressreleases/CADmammographyQandA.

For more information about cancer, visit http://www.cancer.gov, or call NCI's Cancer Information Service at 1-800-4 CANCER.

(Editor Notes: See the statement from the ACR at www.dotmed.com/news/story/3703. Also note that another study recently reported in DOTmed News suggests that CAD is helpful. The American Journal of Roentgenology concluded that CAD increases the breast cancer detection rate and decreases the false negative rate, even though it results in a higher recall rate. See www.dotmed.com/news/story/3615.)

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