By Kay Quinn, St. Louis Post-Dispatch, February 7, 2008

The routine use of digital mammograms created excitement among doctors and patients when the technology went mainstream about 10 years ago. For the previous 35 years, most mammograms were taken on X-ray film and examined by radiologists on a light box.

The excitement was sparked by computerized X-ray images that promise to enhance subtle but significant changes in breast tissue. Radiologists view the digital images on a computer monitor.

But does it really matter which type of mammogram you get annually? Is digital technology really catching more cancers than the old X-ray films?

"I want to make sure I''m getting the best one that would catch anything if I had anything," Tracy Tenner, 40, of St. Louis, said recently as she waited for her digital mammogram at the Breast Health Center at Siteman Cancer Center in St. Louis.

Her words echo the feelings of most women who need the annual screenings.

New data show getting a digital mammogram detects more breast cancers than X-ray film, but only in women in certain groups.

A research project called the Digital Mammographic Imaging Screening Trial showed digital mammograms may be better at detecting breast cancer in:

• Women under 50
• Women with extremely dense breasts
• Pre- or perimenopausal women of any age

Breast density can''t be determined by breast self-exam or a clinical evaluation. It can only be determined through mammography. Women should ask their doctors about whether they fall into this category.

"It''s just merely a physical characteristic of the breast," said Susan Kraenzle, a registered nurse who is the clinical manager of the Breast Health Center. "It''s not that dense breasts are better, or look better, or any of that kind of stuff. It''s a physical characteristic of breast tissue that''s determined by X-ray."

The project showed no apparent advantage in getting a digital mammogram for any woman who falls into all three of these categories:

• Women over 50
• Those without dense breasts
• Those not still having their periods

But the study shows women with dense breasts should be making an extra effort to get to a center that offers digital mammography.

"There are things that we can see a little more clearly with the computerized image in that group of women who tend to have what we call dense breasts that we may not see in the film image," Kraenzle said.

Tenner has dense breasts, something she was told after having her second mammogram.

"It is important," said Tenner, who now plans to have digital mammogram every year. "I would like the one that would show more, you know, so if I had anything they would catch it in time to treat it."

If digital mammography is not available in your area, Kraenzle still advises getting film mammography, regardless of your breast tissue type.

"Do not forgo getting your mammogram because digital mammography is not available in your area," Kraenzle said. "Please, ladies, make sure you get your mammogram. That alone is what''s going to find breast cancer early."

Our "Friend to Friend" section at ksdk.com provides more information about breast cancer and detection.