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 language | English |
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Pages (from-to) | 143-149 |
Number of pages | 7 |
Journal | Breast Cancer Research and Treatment |
Volume | 171 |
Issue number | 1 |
DOIs | |
Publication status | Published - 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