"I think cost is an issue for many hospitals and many facilities because they have existing film equipment in good condition and it's fine to use. But when it becomes time to replace that equipment, I think most people will move towards digital," De Paredes says. "I do think digital is the wave of the future."
Last year, 92 percent of mammography systems (of the 1,776 units) sold in the United States were digital, and it appears most people are convinced this is the way to go.
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According to Karen Schmitt, Director of the Columbia University Breast Cancer Screening Partnership, the convenience far outweighs the cost. "Two radiologists could be looking at the same film at the same time from two different places on the planet. That's really helpful, especially if you are going for a second opinion or you are in a rural area," Schmitt says. "Plus, there aren't a lot of large storage costs because you are storing everything on disk."
The American College of Radiology Imaging Network (ACRIN) in 2005 released the results of one of the largest breast cancer screening studies ever performed, and it is referred to by most experts when discussing the differences between film and digital mammograms. "Digital was shown to be superior to film mammography in some subsets of women," says De Paredes. "In my own practice I use digital exclusively. I think it's the future of mammography as most of general radiology has become."
The primary finding of the study was that, for the entire population of women studied (49,528 women), digital and film mammography had very similar screening accuracy.
Where digital was deemed significantly better (28% better) was in women under 50, those with dense breasts, and those pre- or perimenopausal (defined as women who had a last menstrual period within 12 months of their mammograms).
Hologic Selenia Full Field Digital
Mammography workstation
"There are just a few new analog systems being placed today," McGinty says. "For women under 50 with dense breasts, it has been found that digital is probably a better way to go because of its ability to differentiate the different shapes and structures in the dense tissue. Once you get above that, it's a wash and it doesn't make a whole lot of difference."
