This poster is published under an
open license. Please read the
disclaimer for further details.
Keywords:
Breast, Mammography, Observer performance, Cancer
Authors:
N. Karssemeijer1, R. Hupse1, G. J. den Heeten1, M. Lobbes2, R. M. Mann1; 1Nijmegen/NL, 2Maastricht, LB/NL
DOI:
10.1594/ecr2014/C-0358
Aims and objectives
The degree of mammographic breast density (i.e.
the proportion of fibroglandular or “dense” tissue in the breast) has a considerable impact on the sensitivity of screening mammography.
In women with very fatty breasts,
sensitivity is often reported between 75% and 98%,
whereas in dense breasts,
sensitivity has been reported as low as 48% [1-4].
A large-scale trial of digital mammography (DMIST) noted sensitivity was less than 60% in younger,
pre- and perimenopausal women with dense breasts,
compared to 86% in women with fatty breasts [5].
In breast cancer screening programs,
it is necessary to achieve an optimal balance between sensitivity and recall rates.
The interpretation of screening mammograms is often challenging and highly variable,
but the addition of multiple readers can improve cancer detection rates.
Compared to single reading,
double reading increases cancer detection rates by 5-17% [6] and is,
therefore,
an important consideration when designing screening strategies for a given population.
While numerous variations in screening protocols have been studied,
they have largely sought to apply one protocol across entire populations.
Given the substantial effects of breast density on mammographic sensitivity,
it is not unreasonable to assume that tailoring screening protocols by breast density may improve on current strategies.
In this study,
our aim was to investigate the effect of increasing the number of independent readers on mammography sensitivity,
for dense versus non-dense cases.