Computer-aided detection of breast cancer: has promise outstripped performance?

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Abstract
The article by Gur et al. (1) in this issue of the Journal makes an important contribution to the literature on mammography screening in that it reports no difference in breast cancer detection and recall rates between mammograms read with computer-aided detection and those interpreted by a single radiologist without computer-aided detection. Gur et al. present the recall rates and cancer detection rates for 56 432 screening mammography examinations interpreted before the introduction of computer-aided detection and 59 139 screening mammography examinations interpreted after the introduction of computer-aided detection in their academic radiology practice. No statistically significant differences were observed in those rates. This finding is both remarkable and disappointing, given that computer-aided detection technology has been approved for use by the U.S. Food and Drug Administration (FDA) and is already widely used in clinical practice. Its widespread promotion was almost a promissory note to the public that it would outperform unaided radiologists.