Digital versus screen film mammography: a clinical comparison

Breast carcinoma is the most common malignancy among women in developed countries, and its incidence is on the rise in developing countries. In Malaysia, it accounts for about 30% of newly-diagnosed female cancers [1]. Imaging of the breast can be traced to its earliest origins in 1913 when a surgeon, Albert Salomon, used radiography images of mastectomy specimens to demonstrate the spread of breast carcinoma to the axillary lymph nodes. However it was not until 1960 that the widespread use of mammography became possible. This was attributed to Robert L. Egan who described a mammography technique that was reproducible. The first x-ray unit dedicated to breast imaging was available by 1965. By the 1970s, mammography as a screening device became standard practice [2]. This was because mammography by then had been proven to be the most effective method of detecting early breast carcinoma. The use of mammography in screening of breast carcinoma has been found to significantly reduce the mortality of this disease [3]. The transfer of imaging to the digital format began two decades ago with the introduction of digital radiography. By natural progression, other imaging modalities then adopted the digital technology. The transition from conventional mammography to its digital counterpart, however, was delayed due to the difficulty of producing a full-field digital detector [4]. The first full-field digital mammography unit was approved for sale by the Food and Drug Administration in 2000 [5]. Since then numerous hospitals and medical centres worldwide have installed digital mammography systems.