Jacky Luiten

Recall and outcome of screen‐detected microcalcifications of mammography screening | 79 5 Figure 5.5 C , Spot magnification view shows grouped amorphic calcifications detected at mammography screening. Stereotactic vacuum‐assisted core needle biopsy (9 gauge) yielded multiple specimens with calcifications. D , Photomicrograph shows usual ductal hyperplasia and adenosis. Discussion This retrospective twenty‐year analysis of screen‐detected microcalcifications in the southern part of the Netherlands showed a fivefold increase in the recall rate for suspicious microcalcifications from 0.1% (1997‐1998, the screen‐film mammography [SFM] period) to 0.5% (2015–2016, the full‐field digital mammography [FFDM] period) ( p <0.001). Recalls yielding ductal carcinoma in situ (DCIS) increased from 0.3 per 1000 screening examinations (17/48,721) in the SFM period to 1.1 per 1000 screening examinations (147/131,757) in the FFDM period ( p <0.001), resulting in a decrease in the positive predictive value of recall for suspicious microcalcifications from 51% to 33% ( p <0.001). Overall, one‐third of all recalled microcalcifications proved to be (pre)malignant. Almost 70% of those recalled microcalcifications were DCIS. The distribution in DCIS grade was stable during the 20‐year screening period ( p =0.36), with more than half (53%) being high grade. When comparing the SFM period with the FFDM period, the increase in the number of DCIS per 1000 screening examinations was most pronounced for low grade DCIS,