Study: New Mammograms Good for Young Women

CHICAGO - Digital mammography detects significantly more breast cancers than conventional film in women under 50, in women who have not yet reached menopause, and in women with dense breasts, according to the largest comparison of the two technologies yet published.

The study of nearly 50,000 women, published this week in the New England Journal of Medicine, found digital machines caught about 30 percent more cancers in those groups — while performing no better than film for women over 50 or those with fattier breast tissue.

"This is not a reason for every woman to demand a digital machine," said the study's lead author. "It is a reason for younger women and women with dense breasts to ask whether one is available to them."

Digital mammography works like film mammography but stores images electronically, letting radiologists adjust contrast and zoom — an edge that matters most in dense tissue, where tumors and healthy tissue look alike on film.

The technology has spread quickly since its approval in 2000 but is still in a minority of U.S. screening centers, and it costs three to four times as much as conventional units. Researchers say the findings may pressure insurers and clinics to accelerate the switch for the women it benefits most.

The study arrives amid a long-running debate over when to begin routine screening. Most U.S. guidelines advise annual mammograms from age 40; some panels say starting at 50 is defensible for women at average risk.

Breast cancer is the most common cancer in American women after skin cancer. An estimated 211,000 new cases will be diagnosed this year and about 40,000 women will die of the disease.

Cancer societies cautioned that film mammography remains highly effective and that no woman should skip screening for want of a digital appointment. "The best mammogram is the one you get on time," one advocate said.