PGMI classification of screening mammograms prior to interval cancer. Comparison with radiologists’ consensus classification.

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Congress:

ECR 2016

Poster Number:

C-0673

Type:

Scientific Exhibit

Keywords:

Breast, Mammography, Screening, Quality assurance

Authors:

R. Gullien, J.-G. Andersen, A. E. Haakull, L. Sandvik, P. Skaane; Oslo/NO

DOI:

10.1594/ecr2016/C-0673

DOI-Link:

https://dx.doi.org/10.1594/ecr2016/C-0673

Fig. 1: PGMI results for images in radiologist's classification group 1+2.

Fig. 2: PGMI results for images in radiologist's classification group 3+4.

Fig. 3: PGMI results for images in radiogogist's classification group 1+2 and group 3+4.

Aims and objectives

Breast cancer is one of the most common cancers in women worldwide with 1.7 million new incidents every year and 3.300 new cases every year in Norway. Early detection and reliable diagnosis have proven to be the key to survival, but imaging results can be unclear (1). To decrease the breast cancer mortality, the Norwegian Breast Cancer Screening Program (NBCSP) has been implemented. This population-based program invites women aged 50-69 years biannually for a two-view (cranio-caudal, CC, and mediolateral-oblique, MLO) mammography. A widely used tool...

Methods and materials

Patient Selection All digital mammograms (DM) in this study were performed in the same county. The numbers of screened women in 2007 were 14.329 and 15.612 in 2009. The number of women with IC in 2007 was 29 (IC rate 20.4) and in 2009 the number of IC was 39 (IC rate 25.1). Two women had bilateral cancers, one in 2007 and one in 2009. Two women (one in 2007 and one in2009) had only one breast, due to previous mastectomy. Exclusion criteria Two women...

Results

The number of exams in category 1+2 were n = 50 (73.5 %) and n=18 (26.5 %) in category 3 + 4. For MLO images with radiological score 1+2 the PGMI results were: 52% P+G (n = 26), 28% M (n = 14), 20 % I (n = 10) (Fig. 1). For MLO images with radiological score 3+4 the PGMI results were: 44.4 % P+G (n=8), 39.9 % M (n=7), 16.7 % I (n = 3) (Fig. 2). There were no significant differences between group...

Conclusion

Study limitation There are some limitations in our study. First, the numbers of images with IC are small in both 2007 and 2009. Second, the PGMI classifications system has a subjective factor despite recommendations, criteria and guidelines. Third, the radiologists were biased because they knew they were reviewing cases in which there later on became an interval cancer diagnosis. Strength of our study is that there was a consensus meeting for images with divergent results both for the radiographers and for the radiologists. In spite...

Personal information

References

http://www.kreftregisteret.no/no/Generelt/Publikasjoner/Mammografiprogrammet/Kvalitet/ Gullien, R; Andersen, JG; Haakull, AE. Identifying the most common deviations in mediolateral-oblique (MLO) mammograms classified as "moderate" before and after implementation of improvement initiatives. European Congress of Radiology; 2010. van Dijck, JA; Verbeek AL; Hendriks JH; Holland R. The current detectability of breast cancer in a mammographic screening program. A review of the previous mammograms of interval and screening-detected cancers. Cancer; 1993. Skaane P; Sebuodegard S; Gur D; Gullien R; Hofvind S. Screen-detected and Interval Cancers before, During, and after Implementation of Digital...