When she was 39, Christina Koenig, a single mother, noticed a lump in her breast and went to the doctor.
A mammography didn't show anything, but a biopsy of the lump revealed Koenig had breast cancer.
"It was like, oh my god, I can't believe this didn't show up," said Koenig, a Chicago resident who, five years later, is in remission. "I guess it's just not a perfect science. I was surprised but did not question it."
Koenig falls into a group of women who don't benefit as much from traditional film mammography as others: Women who are either under 50, have not gone through menopause, or tend to have lumpy or dense breasts.
A 2005 study done by the American College of Radiology Imaging Network showed that digital mammography diagnosed 28 percent more cancers in women under 50 with dense breasts, making digital mammography a better option for them. But current digital systems are sometimes too expensive for many hospitals and imaging centers.
Until now. Radiologists hope that the Food and Drug Administration's approval of a new, cheaper digital system will allow more women to benefit from this newer technology.
The Fuji Computer Radiology for Mammography is not the first digital system approved by the FDA, but at half the price of other digital-screening machines, it is more cost effective, and its design works better.
"Ever since we got these results, radiologists have wanted to go digital," said Dr. Etta D. Pisano, director of University of North Carolina Biomedical Research Imaging Center and the lead researcher on the 2005 study. "The Fuji system makes a difference. Because it is cheaper ... you won't need to do a forklift upgrade."
The Fuji system replaces film cassettes with film plates that receive the X-ray data. The processor then uses a laser to read the information on the plate and turns it into a digital signal.
"This will change the face of the mammography business," said Gerald Durney, administrative director of Radiology at the Lenox Hill Hospital in New York, which will receive the Fuji system in late summer.
Digital technology has been used for other types of X-rays, like hand X-rays or CAT scans, since the early 1990s. Breast imaging fell behind because it requires higher resolutions, which earlier digital technology could not provide.
The technology will allow rural areas to benefit from radiologists in more specialized and centralized locations, said Cathy Fischer, administrative director of the Norman J. Vinger Center for Breast Care at Gundersen Lutheran in La Crosse, Wis.
For example, Gundersen Lutheran plans to install a Fuji system in a facility in Decorah, Iowa, which is 100 miles from La Crosse. Images can be sent electronically from Iowa to be read by expert radiologists.
The system can also read other digital X-rays, which makes it more cost effective.
"I could take a chest X-ray and bring it to this same system, and it would turn out a good chest image," Durney said. "This is key for smaller hospitals."
Doctors caution, however, that the technology is only as good as its user.
"It is still more important who is interpreting the mammography than whether it is done on film screen or digital," said Dr. James Brenner, chief of breast imaging at the University of California at San Francisco and president of the Society of Breast Imaging.
Pisano also warns that women should not delay or avoid getting a mammogram just because it is not digital.