TY - JOUR
T1 - Impact of the second reader on screening outcome at blinded double reading of digital screening mammograms
AU - Coolen, Angela M. P.
AU - Voogd, Adri C.
AU - Strobbe, Luc J.
AU - Louwman, Marieke W. J.
AU - Tjan-Heijnen, Vivianne C. G.
AU - Duijm, Lucien E. M.
PY - 2018/8/14
Y1 - 2018/8/14
N2 - BACKGROUND: To determine the impact of the second reader on screening outcome at blinded double reading of digital screening mammograms. METHODS: We included a consecutive series of 99,013 digital screening mammograms, obtained between July 2013 and January 2015 and double read in a blinded fashion. During 2-year follow-up, we collected radiology, surgery and pathology reports of recalled women. RESULTS: Single reading resulted in 2928 recalls and 616 screen-detected cancers (SDCs). The second reader recalled another 612 women, resulting in 82 additional SDCs. Addition of the second reader increased the recall rate (3.0% to 3.6%, p < 0.001), cancer detection rate (6.2-7.0 per 1000 screens, p < 0.001) and false positive recall rate (24.4-28.7 per 1000 screens, p < 0.001). Positive predictive value of recall (21.0% vs. 19.7%, p = 0.20) and of biopsy (52.1% vs. 50.9%, p = 0.56) were comparable for single reading and blinded double reading. Tumour characteristics were comparable for cancers detected by the first reader and cancers additionally detected by the second reader, except of a more favourable tumour grade in the latter group. CONCLUSIONS: At blinded double reading, the second reader significantly increases the cancer detection rate, at the expense of an increased recall rate and false positive recall rate.
AB - BACKGROUND: To determine the impact of the second reader on screening outcome at blinded double reading of digital screening mammograms. METHODS: We included a consecutive series of 99,013 digital screening mammograms, obtained between July 2013 and January 2015 and double read in a blinded fashion. During 2-year follow-up, we collected radiology, surgery and pathology reports of recalled women. RESULTS: Single reading resulted in 2928 recalls and 616 screen-detected cancers (SDCs). The second reader recalled another 612 women, resulting in 82 additional SDCs. Addition of the second reader increased the recall rate (3.0% to 3.6%, p < 0.001), cancer detection rate (6.2-7.0 per 1000 screens, p < 0.001) and false positive recall rate (24.4-28.7 per 1000 screens, p < 0.001). Positive predictive value of recall (21.0% vs. 19.7%, p = 0.20) and of biopsy (52.1% vs. 50.9%, p = 0.56) were comparable for single reading and blinded double reading. Tumour characteristics were comparable for cancers detected by the first reader and cancers additionally detected by the second reader, except of a more favourable tumour grade in the latter group. CONCLUSIONS: At blinded double reading, the second reader significantly increases the cancer detection rate, at the expense of an increased recall rate and false positive recall rate.
KW - RECALL RATE
KW - BREAST
KW - PROGRAM
KW - NETHERLANDS
KW - CANCERS
KW - SENSITIVITY
KW - ARBITRATION
U2 - 10.1038/s41416-018-0195-6
DO - 10.1038/s41416-018-0195-6
M3 - Article
C2 - 30038325
SN - 0007-0920
VL - 119
SP - 503
EP - 507
JO - British Journal of Cancer
JF - British Journal of Cancer
IS - 4
ER -