Detection rates for small, invasive breast cancers (1.0 cm or less) increased by 164% and cancers were found in women at a younger age when radiologists used computer aided detection (CAD) to assist in reading mammograms, according to a new study published in the October issue of the American Journal of Roentgenology (AJR). The mean age at screening detection of cancer with CAD was 5.3 years younger than in those for whom CAD was not used. Overall, the study found that detection rates for breast cancer increased by 16.1%. The study used R2 Technology, Inc.’s ImageChecker mammography CAD system and is the first to prospectively evaluate in a clinical practice CAD’s impact on both the size of tumors detected and women’s age at diagnosis.
“Finding breast cancer when it is small and localized can be critical to a woman’s survival,” said lead investigator Dr. Tommy E. Cupples, of the South Carolina Comprehensive Breast Center at Palmetto Richland Memorial Hospital in Columbia, SC. “Our use of R2’s CAD helped to substantially increase detection of small, invasive cancers, which are often the easiest for radiologists to miss and can thus be life-threatening for women. Additionally, our study showed that CAD can help radiologists find these cancers in women more than five years younger — thus, helping us find the cancers potentially five ‘mammography cycles’ sooner. Earlier detection can have important implications for a woman’s prognosis and survival.”
The new study, conducted in a regional hospital between January 1, 1998, and December 31, 2000, evaluated radiologists’ performance on 7,872 consecutive screening mammograms before CAD was installed at the center and then compared the results with the same radiologists’ performance on 19,402 consecutive exams, when using CAD. The study measured recall rates, biopsy rates and cancer detection rates, as well as the type, size and stage of cancers found by screening with and without CAD. The number of women recalled for subsequent evaluation increased by only 8.1%, while the number of women in whom biopsies were performed increased by only 6.7%, coincident with an important increase of 16.1% in breast cancer detection rates.
“This study underscores the increasingly important role that R2’s ImageChecker CAD system plays in helping physicians detect breast cancer earlier,” said Dr. Ronald A. Castellino, R2 Technology’s chief medical officer. “Our technology should give radiologists added confidence that they are providing their patients with the best care possible.”
This year, more than 200,000 women in the United States will be diagnosed with invasive breast cancer and more than 40,000 women will die from this disease, according to American Cancer Society (ACS) estimates. When diagnosed at an early stage, when the tumor is confined to the breast, the ACS estimates that a woman’s five-year survival rate is 98%. Once the cancer has spread regionally, the five-year survival rate drops to 80% and then to 26% for women with distant metastases. The ACS recommends that women age 40 and older should get screening mammograms every year.
CAD technology is used by increasing numbers of radiologists as “a second pair of eyes” when reading mammograms. Five independent prospective clinical studies* from academic and community practices showed that the use of R2’s CAD resulted in 6.6 percent to 19.5 percent more cancers detected. Independent studies* comparing CAD performance on architectural distortions, cases graded by difficulty, and small invasive breast cancers all demonstrate the advantage of R2’s market-leading CAD algorithm.
R2’s ImageChecker system was the first CAD system approved by the U.S. Food and Drug Administration (FDA) for use with film-based mammography in 1998 and for digital mammography in 2001. Since 1998, the company has received multiple supplemental approvals for technological and clinical advances and owns or has exclusive worldwide rights in more than 120 issued and pending patents. To date, more than 2000 ImageChecker CAD systems have been shipped worldwide and this year approximately nine million women will have their mammograms interpreted with the aid of R2’s leading CAD technology.