Incorporation of the technologist's opinion for arbitration of discrepant assessments among radiologists at screening mammography

Angela M. P. Coolen*, Joost R. C. Lameijer, Adri C. Voogd, Luc J. Strobbe, Marieke W. J. Louwman, Vivianne C. G. Tjan-Heijnen, Lucien E. M. Duijm

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Web of Science)

Abstract

We determined whether the addition of the technologist's opinion may be helpful in deciding if discordant readings at blinded double reading should be recalled.

A consecutive series of 99,013 digital screening mammograms, obtained between July 2013 and January 2015, were included. All mammograms were first interpreted by a technologist and then double read in a blinded fashion by a team of 13 screening radiologists. All concordant and discordant positive readings among radiologists were recalled.

Out of 3562 recalls, 998 women were recalled after a discordant reading. Of these women, 337 (33.8%) had a positive technologist assessment, of which 40 (11.9%) were diagnosed with breast cancer. Sixty women with a negative technologist assessment (60/661, 9.1%) were diagnosed with breast cancer (p = 0.16). Recall rate would have decreased with technologist arbitration (3.6% vs. 2.9%, p <0.001). Cancer detection rate decreased with 8.5%, from 7.1/1000 screens to 6.5/1000 screens (p = 0.10). Among women with a positive technologist assessment, the probability of breast cancer was highest in case of suspicious microcalcifications and lowest for suspicious masses (30.4% (17/56) versus 7.0% (16/212), p <0.001). Breast cancers were diagnosed in all groups of mammographic abnormalities, except in women with a suspicious asymmetry and a negative technologist assessment.

Assessment by a technologist does not provide a significant discriminating ability in case of a discordant radiologist reading and, taking into account the decrease in cancer detection rate, does not appear to be a suitable arbitration strategy for discordant recalls at blinded double reading.

Original languageEnglish
Pages (from-to)143-149
Number of pages7
JournalBreast Cancer Research and Treatment
Volume171
Issue number1
DOIs
Publication statusPublished - Aug 2018

Keywords

  • Breast cancer screening
  • Digital mammography
  • Radiologist blinded double reading
  • Mammography technologist
  • CANCER-DETECTION RATE
  • FILM MAMMOGRAPHY
  • RECALL RATE
  • 3RD READER
  • PERFORMANCE
  • RADIOGRAPHERS
  • PROGRAM
  • SENSITIVITY
  • EXPERIENCE
  • NUMBER

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