Current Status of Full-Field Digital Mammography 1

Screen-film mammography has been studied extensively for the past 30 years, and because of many large randomized screening trials, it is known to reduce breast cancer mortality by approximately 18%-30% (1,2). The decline in the rate of breast cancer death in the past few years may be due in part to the widespread use of this imaging test (3,4). However, while standard screen-film mammography is very good, it is neither perfectly sensitive nor highly specific. Dense breast tissue and diffuse involvement of the breast with tumor tend to reduce the sensitivity of screening mammography (5-7). Approximately 10%-20% of breast cancers that are detected at self-breast examination or physical examination are not visible at screen-film mammography (6,8,9). In addition, when lesions are detected at mammography and biopsy is recommended by experienced radiologists, only 5%-40% of lesions prove to be malignant (10-12). Clearly, there is room for improvement in both breast cancer detection and lesion characterization. A major limitation of screen-film mantmography is the film itself. The film serves as the medium of image acquisition, storage, and display. Breast cancer is often similar in