Purpose
Breast cancer screening shows wide interobserver (radiologist) variability in the interpretation of screening mammograms.[1-3] This variability depends, among other factors, on the protocols for mammogram reading, the specific characteristics of each patient and breast and, to a large extent, on the radiologist’s experience. Radiologists have been observed to differ, sometimes substantially, both in their interpretations of mammograms and in their recommendations for follow-up. Therefore, variability in mammogram reading may adversely affect the quality of screening programs by affecting recall rates, which may be low (undetected...
Methods and Materials
Ethical issue This study will follow the national and international guidelines stated at the Declaration of Helsinki and, furthermore, it will comply with the legal procedures regarding rules of data confidentiality (Law 15/1999 of December the 13th, about Personal Data Protection [LOPD]). Mammogram selection A random sample of 200 mammograms from asymptomatic women aged 50 to 64 years old who had participated in the first and second rounds of a population-based breast cancer screening program in Spain was selected. A total of 33435 mammograms were...
Results
Twenty-eight radiologists read the same 200 screening mammograms, representing a total of 5587 readings (13 lost readings). Based on the interpretations of these radiologists, the false-positive rate was 36% (1728 of 4750) and the false-negative rate was 16% (132 of 837). Therefore, the average sensitivity was 84% (705 of 837) (range, 63-97%) and the average specificity was 64% (3022 of 4750) (range, 34-85%) (Table 1). Table 1 The seven radiologists not routinely interpreting mammograms showed an average sensitivity of 84% (177 of 210) (range, 63-97%)...
Conclusions
Discussion In the present study, wide variability in radiologists&rsquo interpretations of the sample of mammograms was observed. The group of radiologists not routinely interpreting mammograms showed no differences in average sensitivity in mammogram interpretation compared with routine readers but showed significantly less specificity and accuracy. Of the various experience-related factors used to evaluate this variability, annual reader volume was only important when radiologists not routinely interpreting mammograms were compared with routine readers, the latter showing greater specificity and accuracy. In contrast, no significant differences in...