The New Digital Mammography

Last month I went for my annual mammogram at the breast center where I have had every mammogram since my baseline at age 40 ten years ago. I filled out the forms, was escorted into the changing room (which is really no bigger than a small closet. It has a bench and a hook.) The nurse knocked on the door and I entered the mammo room. I asked her if this was the new digital mammo machine. She said "no". I expressed my disappointment and explained that as an advocate, I was interested in the new machinery. When she read my chart and realized that I was a survivor, she told me that all women who had breast cancer were routinely being screened with the newer technology. We switched to the other room. I was disappointed. The machine, a GE model, looked exactly the same. The procedure was the same - position, squish, hold your breath and you're done. To be fair, this is the first mammo I have had in 3 years (since I was diagnosed with breast cancer) where they did not take additional views. There is no difference in the feeling of compression, or the length of the exam.

When I saw my breast surgeon two days later, I asked him about the machine. I had read a lot about it and wanted his opinion. He told me that the digital machine could zoom in to denser tissue. From what I've read, I believe he meant that the computer technology could change the angle of view, or depth of the picture. I know there have been several small studies done to date which have found no significant difference in the detection of cancer. Simply put, the radiologist must still know how to read the material, whether it is computer-generated or a radiologic film. In one study, the radiologists found as many (and missed as many) on both types of machines. The advantage to the digital machine is that it can maneuver the pictures. Storage is easier (images can be stored on a computer disc). One of the best parts of the digital technology is the application for areas worldwide where a radiologist is not always available. I have a friend in the Phillipines. This country consists of several islands, hundreds of miles apart from each other. Although they have a mammography machine on one of the outer islands, they can not afford to hire a full-time radiologist. In the past, they have had students, or any medical personnel they could find, read the films. With a digital machine, they can email the pictures to a radiologist any where in the world. The storage also takes less space, takes seconds to retrieve and produces clearer images.

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