Breast Cancer Screening: Comparison of Screening Modalities in Taiwan

Abstract

Background: Screening for breast cancer is an important method for reducing the death rate in the Western
world over the past 20-30 years. On this basis, since 2004 , the National Health Bureau of Taiwan has also
begun providing free screening service. The purpose of the current research is to compare the efficacy of the
three-mammography modalities for breast cancer identification.
Methods: Between July 2004 and December 2010, a total of 23,513 eligible women underwent screening
mammography. 6804 of these received screen-film mammography (SFM), 1610 received computedradiography (CR) mammography, and 15,099 received digital mammography (DM). The detection rate of
carcinoma-in-situ, early detection rate of cancer, and the overall cancer detection rate of each modality was
calculated. To determine the statistical significance of performance differences between these modalities
Chi-square test was used.
Results: SFM callback rate was 12.23%, cancer detection rate was 5.29%, Ductal carcinoma in situ (DCIS)
detection rate was 1.76%. Computed radiography’s callback rate was 12.67%, with a cancer detection rate
of 6.21% and DCIS detection rate of 1.24%. DM has the highest callback rate of 16.2%, but also the highest
rate of cancer detection and DCIS detection rate of 9.21% and 3.58% respectively. DM was found to have
better cancer detection rate and DCIS detection rate as compared to SFM and CR, it is only statistically
significant when compared to SFM. Although DM has better cancer and DCIS detection rates, it is also
associated with higher callback rate.
Conclusions: In terms of image quality and greater contrast, optical mammography has many advantages
when opposed to screen-film and computed radiography mammography. In the Asian population, where
women have higher breast densities, this is particularly vital. The incidence of Taiwanese breast cancer is
steadily growing