Can high school students help to improve breast radiologists in detecting missed breast cancer lesions on full-field digital mammography?

T. J. A. van Nijnatten*, M. L. Smidt, B. Goorts, S. Samiei, I. Houben, E. M. Kok, J. E. Wildberger, S. G. F. Robben, M. B. I. Lobbes

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Web of Science)


Aim: To investigate whether full-field digital mammography (FFDM) and contrast-enhanced mammography (CEM), evaluated by non-experienced high school students, improves detection of missed breast cancer lesions on FFDM, in the same cohort of patients.

Methods: Non-experienced first- and second year high school students examined fourteen cases of patients diagnosed with breast cancer. These cases consisted of missed breast cancer lesions on FFDM by a breast radiologist. Sensitivity of assessment of the students on FFDM and CEM was analysed and compared with the initial results of the breast radiologists.

Results: A total of 134 high school students participated in this study. Mean age was 12.8 years (range 10-14). Based on FFDM, mean overall sensitivity of the students was 29.2% (18.9 - 39.6%). When recombined CEM images were used, mean overall sensitivity of students improved to 82.6% (74.0 - 91.2%) (p=0.001). Mean overall sensitivity of FFDM exams evaluated by radiologists was 75.7% (64.2 - 87.3%), which was lower when compared to student's evaluations on recombined CEM exams, yet not statistically significant (p=0.098).

Conclusions: Contrast-enhanced mammography evaluated by non-experienced high school students might improve detection rate of breast cancer when compared to evaluations of only full-field digital mammography by radiologists.

Original languageEnglish
Pages (from-to)765-771
Number of pages7
JournalJournal of Cancer
Issue number3
Publication statusPublished - 2019


  • mammography
  • contrast-enhanced mammography
  • breast cancer
  • sensitivity
  • students
  • MRI
  • CESM

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