Background: We sought to test the hypothesis that compared to analog film screen mammography:
1.Digital mammography with its higher KVp misses more small invasive lesions
2.Ultrasound detected lesions are as a result increased in number
3.DCIS lesions are over represented on digital studies
4.There is a tendency to potential overdiagnosis
Materials and methods: Retrospective review of population screened by digital mammography and dedicated adjunct breast ultrasound for period Feb 2013- Dec 2013.
3040 Screening cases were reviewed. Results were compared with 2003 Israel screening ultrasound and analog mammography data, and general published analog and digital population data, including tomosynthesis.
Results: 23 carcinomas detected in population within study period
17 invasive lesions detected; 8 of them (47%) - on adjunct ultrasound only
Additional invasive cancers detection rate by ultrasound was 2.6/1000 women screened
Mean size of sonographically only detected invasive cancers was 9 mm
6 DCIS lesions detected on digital mammography, 1 of them (17%) - over age 65
2 of 17 (12%) of invasive lesions detected over age 70
Conclusions: Ultrasound appears to be an especially important adjunct study within the context of digital screening mammography.
Small prognostically significant invasive carcinomas are often detected by add on US and missed on Digital Mammography.
DCIS was not over represented.
There is a potential case to be made for overdiagnosis of both DCIS and invasive lesions over age of 65.
