fb-pixelComputerized aid for mammograms faulted - The Boston Globe Skip to main content

Computerized aid for mammograms faulted

Study finds no benefit, but the technology adds to costs

NEW YORK — The stocks of Hologic Inc. and Icad Inc., makers of medical imaging equipment, fell after a study found that breast cancer screening performed with computer-aided technology failed to find more tumors.

The technology, approved in the United States in 1998, is used in 90 percent of mammograms, according to the study’s lead researcher, Constance Lehman, director of breast imaging and codirector of the Avon Foundation Comprehensive Breast Evaluation Center at Massachusetts General Hospital in Boston. That should end, she said.

“There is absolutely no question from our research that computer-aided detection offers no benefit to catching cancers that otherwise would have been missed or improving performance,” Lehman said.

Advertisement



“We should certainly stop charging for it. We want to use our health-care dollars on technology that will improve the health of our patients.”

Hologic, based in Bedford, Mass., gets about 37 percent of its sales from breast health products. Icad, of Nashua, N.H., relies entirely on revenue from medical imaging systems.

The findings sent Hologic stock down 5.6 percent to $37.76, the biggest one-day decline since November 2013. Icad’s shares fell 10 percent to $3.37.

Mammograms have been the focus of controversy since 2009, when the Preventive Services Task Force recommended that most women under 50 forgo breast cancer screening and for women 50 and older to do it every other year instead of annually. The guidelines were intended to reduce the risk of false positive findings and unnecessary biopsies.

The American Cancer Society, however, says the tests should be performed each year starting at 40.

The current study concluded that regardless of how often mammograms are performed, computer-aided detection does not improve their accuracy.

The study examined mammograms from 323,973 women who underwent digital screening with or without the computerized assistance, which highlights potential problems for radiologists to review after an initial analysis. Cancer was detected in the same proportion of women regardless of which method was used, with similar accuracy in finding actual tumors and ruling out false positives.

Advertisement



There is a “significant body of clinical literature” that proves the technology enhances the performance of radiologists and increases cancer detection, Icad chief executive Ken Ferry said in an e-mail. The devices are approved by the Food and Drug Administration, a rigorous process that requires proof of safety and benefit, he noted.

Hologic had no comment.

The computer assistance may have benefits unrelated to finding more cancers, said Vijay Kumar, an analyst at Evercore ISI in New York. The technology can boost the efficiency of radiologists, allowing them to examine images more quickly and boosting productivity, he said. With the equipment already available at most health-care facilities, their use may not decline, he said.

Insurance companies pay more than $20 per mammogram for use of the technology, and Medicare pays about $7, the study found.

Aetna Inc. will review the study and take it into consideration when deciding on coverage, a spokeswoman  said. Cigna Corp. declined to comment.

The findings back up two previous studies that generated similar results but were criticized because they involved only older women or older technology that was read by less experienced radiologists.

The latest study, published in the journal JAMA Internal Medicine and funded in part by the National Cancer Institute, is one of the largest and was designed to address those shortcomings, Lehman said.

Advertisement



The findings won’t change recommendations from the American Congress of Obstetricians and Gynecologists, which establishes mammography guidelines that are followed by many insurers. While doctors recommend women get regular mammograms, the type of imaging used for the screening and any computerized assistance is done at the discretion of the radiologists, said Christopher Zahn, a vice president at the organization.