Impact of ACRIN DMIST Results on the Technologist and Mammography Practice

ACRIN DMIST was sponsored by the National Cancer Institute and enrolled a total of 49,528 asymptomatic women to compare the performance of digital and screen-film mammography for screening. The study used a paired design in which each woman received both a digital and screen-film mammography examination performed by the same technologist in randomized order. Mammograms were interpreted independently by two radiologists. All relevant follow-up information including cancer status was available for 42,760 of the enrolled women (86.3%). For the full study population with complete follow up, the diagnostic accuracy of digital and screen-film mammography was similar, as assessed by ROC curve areas. For the overlapping subgroups of women under age 50, pre- or peri-menopausal women, and women with heterogeneously dense or extremely dense breasts, digital was found to be superior to screen-film mammography with statistical significance. The details of these results and their implications for your mammography practice are discussed.