Comparing the Effectiveness of Digital and Analog Mammography in Breast Cancer Diagnosis and Screening: A Systematic Review and Meta-Analysis

Background & Objectives: Breast cancer is the most common cancer among women and one of the leading causes of death in the productivity ages. Mammography screening is the main method for the diagnosis of breast cancer. While analog mammography counts as the standard method of screening, the digital one can be an alternative. This review compared the effectiveness and safety of these technologies. Materials & Methods: In order to collect evidence of the effectiveness of analog and digital mammography, a systematic review of diagnostic accuracy studies from 1990 to March 2014 was conducted. The most relevant databases included Abstracts of Reviews of Effects (DARE), NHS Economic Evaluation Database (NHS EEDs), Cochrane Database of Systematic Reviews, TRIP, PubMed, and Medline. The keywords included mammography and its roots. After identifying the appropriate studies, the quality was evaluated by QUADAS, and the meta-analysis was used for extracted data pooling. Results: Of all the 35,284 related studies, 166 were selected after topic review. Subsequently, 13 studies were selected for analysis, removing duplicates and abstracts or full paper reviews. The quality of 9 studies was good while that of the rest was average. The meta-analysis revealed that the sensitivity of analog and digital mammography in women under 50 years of age was 0.61 and 0.81, respectively. Conclusion: Owing to the higher sensitivity and safety of digital mammography and based on the increasing prevalence of breast cancer among the Iranian women, especially in the ages of 45-50, we recommend digital rather than analog mammography for breast cancer screening and diagnosis.