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Computer software used to help decipher screening mammograms reduces interpretation accuracy, increases the rate of unnecessary biopsies, and offers no clear improvement in the detection of invasive breast cancer, the largest and most comprehensive community-based study of the technology has found.

A random sampling of 2.3% of the imaging centers that meet Mammography Quality Standards Act (MQSA) certification showed that the national median cash price for a screening mammogram is more than double the price that is reimbursed by Medicare.

New subgroup analyses from the Digital Mammographic Imaging Screening Trial (DMIST) Investigators Group confirm previous results that digital screening mammography is significantly more accurate than film screening mammography in young women with dense breasts but not in women overall.

Nine weeks of trastuzumab (Herceptin) given concurrently with single-agent docetaxel (Taxotere) or vinorelbine (Navelbine) prior to combination chemotherapy improves survival in HER2-positive breast cancer patients, compared with no trastuzumab, with the docetaxel regimen having a slight advantage over vinorelbine.

ARLINGTON, Virginia-Data from more than 40,000 women who underwent both digital and film mammography at 33 sites in the US and Canada show that, while the techniques have similar overall diagnostic accuracy in breast cancer screening, digital mammography is more accurate in women under the age of 50 years, women with radiographically dense breasts, and pre- or perimenopausal women.

MILAN, Italy-In women with fibroglandular or dense breasts, magnetic resonance imaging (MRI) is more sensitive than mammography for detection of multiple malignant foci, suggesting that a dynamic MRI examination is warranted before treatment planning in this group of patients, a team of Italian radiologists and surgeons has concluded. Yet in breasts with an almost completely fatty pattern, both techniques had comparable sensitivity, their multicenter, prospective, nonrandomized study showed. Further, while MRI achieved a 17% gain in sensitivity over mammography in detection of invasive foci, the two techniques had similar sensitivity in detection of in situ foci, and neither had a strong positive predictive value (PPV), the researchers found.

ATLANTA-Compared with independent double reading of mammograms, consensus double reading detects slightly more cancers while significantly decreasing recall rates, thereby minimizing the anxiety that women might experience from undergoing a second mammogram, Susan Harvey, MD, said at the 102nd Annual Meeting of the American Roentgen Ray Society (abstract 63).

The journal Lancet recently published an important analysis from six physicians at Weill Cornell Medical College (359:404-406, 2002), rebutting an article published in an earlier issue of Lancet (358:1340-1342, 2001) that cast doubt on the value of mammography in preventing death from breast cancer.

WASHINGTON-Amid continuing controversy over the effectiveness of screening mammography for breast cancer, the US Preventive Services Task Force (USPSTF) has extended its recommendations to include women between the ages of 40 and 49, after concluding that the procedure reduces breast cancer deaths.