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05.05.2018 | Epidemiology

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

verfasst von: 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

Erschienen in: Breast Cancer Research and Treatment | Ausgabe 1/2018

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.
Literatur
1.
Zurück zum Zitat Sankatsing VDV, van Ravesteyn NT, Heijnsdijk EAM et al (2017) The effect of population-based mammography screening in Dutch municipalities on breast cancer mortality: 20 years of follow-up. Int J Cancer 141:671–677CrossRefPubMed Sankatsing VDV, van Ravesteyn NT, Heijnsdijk EAM et al (2017) The effect of population-based mammography screening in Dutch municipalities on breast cancer mortality: 20 years of follow-up. Int J Cancer 141:671–677CrossRefPubMed
2.
Zurück zum Zitat European Commission. Directorate-general for health and consumer protection, Perry N, Puthaar E (2006) European guidelines for quality assurance in breast cancer screening and diagnosis, 4th edn. Office for Official Publications of the European Communities, Luxembourg European Commission. Directorate-general for health and consumer protection, Perry N, Puthaar E (2006) European guidelines for quality assurance in breast cancer screening and diagnosis, 4th edn. Office for Official Publications of the European Communities, Luxembourg
3.
Zurück zum Zitat Duijm LE, Louwman MW, Groenewoud JH, van de Poll-Franse LV, Fracheboud J, Coebergh JW (2009) Inter-observer variability in mammography screening and effect of type and number of readers on screening outcome. Br J Cancer 100:901–907CrossRefPubMedPubMedCentral Duijm LE, Louwman MW, Groenewoud JH, van de Poll-Franse LV, Fracheboud J, Coebergh JW (2009) Inter-observer variability in mammography screening and effect of type and number of readers on screening outcome. Br J Cancer 100:901–907CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Gur D, Sumkin JH, Hardesty LA et al (2004) Recall and detection rates in screening mammography. Cancer 100:1590–1594CrossRefPubMed Gur D, Sumkin JH, Hardesty LA et al (2004) Recall and detection rates in screening mammography. Cancer 100:1590–1594CrossRefPubMed
5.
Zurück zum Zitat Klompenhouwer EG, Voogd AC, den Heeten GJ et al (2015) Discrepant screening mammography assessments at blinded and non-blinded double reading: impact of arbitration by a third reader on screening outcome. Eur Radiol 25:2821–2829CrossRefPubMed Klompenhouwer EG, Voogd AC, den Heeten GJ et al (2015) Discrepant screening mammography assessments at blinded and non-blinded double reading: impact of arbitration by a third reader on screening outcome. Eur Radiol 25:2821–2829CrossRefPubMed
6.
Zurück zum Zitat Shaw CM, Flanagan FL, Fenlon HM, McNicholas MM (2009) Consensus review of discordant findings maximizes cancer detection rate in double-reader screening mammography: Irish National Breast Screening Program experience. Radiology 250:354–362CrossRefPubMed Shaw CM, Flanagan FL, Fenlon HM, McNicholas MM (2009) Consensus review of discordant findings maximizes cancer detection rate in double-reader screening mammography: Irish National Breast Screening Program experience. Radiology 250:354–362CrossRefPubMed
7.
Zurück zum Zitat Duijm LE, Groenewoud JH, Fracheboud J, de Koning HJ (2007) Additional double reading of screening mammograms by radiologic technologists: impact on screening performance parameters. J Natl Cancer Inst 99:1162–1170CrossRefPubMed Duijm LE, Groenewoud JH, Fracheboud J, de Koning HJ (2007) Additional double reading of screening mammograms by radiologic technologists: impact on screening performance parameters. J Natl Cancer Inst 99:1162–1170CrossRefPubMed
8.
Zurück zum Zitat Torres-Mejia G, Smith RA, Carranza-Flores Mde L et al (2015) Radiographers supporting radiologists in the interpretation of screening mammography: a viable strategy to meet the shortage in the number of radiologists. BMC Cancer 15:410CrossRefPubMedPubMedCentral Torres-Mejia G, Smith RA, Carranza-Flores Mde L et al (2015) Radiographers supporting radiologists in the interpretation of screening mammography: a viable strategy to meet the shortage in the number of radiologists. BMC Cancer 15:410CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Klompenhouwer EG, Voogd AC, den Heeten GJ et al (2015) Blinded double reading yields a higher programme sensitivity than non-blinded double reading at digital screening mammography: a prospected population based study in the south of The Netherlands. Eur J Cancer 51:391–399CrossRefPubMed Klompenhouwer EG, Voogd AC, den Heeten GJ et al (2015) Blinded double reading yields a higher programme sensitivity than non-blinded double reading at digital screening mammography: a prospected population based study in the south of The Netherlands. Eur J Cancer 51:391–399CrossRefPubMed
10.
Zurück zum Zitat American College of Radiology. BI-RADS Committee (2013) ACR BI-RADS atlas: breast imaging reporting and data system, 5th edn. American College of Radiology, Reston American College of Radiology. BI-RADS Committee (2013) ACR BI-RADS atlas: breast imaging reporting and data system, 5th edn. American College of Radiology, Reston
11.
Zurück zum Zitat Pauli R, Hammond S, Cooke J, Ansell J (1996) Comparison of radiographer/radiologist double film reading with single reading in breast cancer screening. J Med Screen 3:18–22CrossRefPubMed Pauli R, Hammond S, Cooke J, Ansell J (1996) Comparison of radiographer/radiologist double film reading with single reading in breast cancer screening. J Med Screen 3:18–22CrossRefPubMed
12.
Zurück zum Zitat van den Biggelaar FJ, Nelemans PJ, Flobbe K (2008) Performance of radiographers in mammogram interpretation: a systematic review. Breast 17:85–90CrossRefPubMed van den Biggelaar FJ, Nelemans PJ, Flobbe K (2008) Performance of radiographers in mammogram interpretation: a systematic review. Breast 17:85–90CrossRefPubMed
13.
Zurück zum Zitat Debono JC, Poulos AE, Houssami N, Turner RM, Boyages J (2015) Evaluation of radiographers’ mammography screen-reading accuracy in Australia. J Med Radiat Sci 62:15–22CrossRefPubMed Debono JC, Poulos AE, Houssami N, Turner RM, Boyages J (2015) Evaluation of radiographers’ mammography screen-reading accuracy in Australia. J Med Radiat Sci 62:15–22CrossRefPubMed
14.
Zurück zum Zitat Tonita JM, Hillis JP, Lim CH (1999) Medical radiologic technologist review: effects on a population-based breast cancer screening program. Radiology 211:529–533CrossRefPubMed Tonita JM, Hillis JP, Lim CH (1999) Medical radiologic technologist review: effects on a population-based breast cancer screening program. Radiology 211:529–533CrossRefPubMed
15.
Zurück zum Zitat Pisano ED, Gatsonis C, Hendrick E et al (2005) Diagnostic performance of digital versus film mammography for breast-cancer screening. N Engl J Med 353:1773–1783CrossRefPubMed Pisano ED, Gatsonis C, Hendrick E et al (2005) Diagnostic performance of digital versus film mammography for breast-cancer screening. N Engl J Med 353:1773–1783CrossRefPubMed
16.
Zurück zum Zitat Bluekens AM, Holland R, Karssemeijer N, Broeders MJ, den Heeten GJ (2012) Comparison of digital screening mammography and screen-film mammography in the early detection of clinically relevant cancers: a multicenter study. Radiology 265:707–714CrossRefPubMed Bluekens AM, Holland R, Karssemeijer N, Broeders MJ, den Heeten GJ (2012) Comparison of digital screening mammography and screen-film mammography in the early detection of clinically relevant cancers: a multicenter study. Radiology 265:707–714CrossRefPubMed
17.
Zurück zum Zitat van Luijt PA, Fracheboud J, Heijnsdijk EA, den Heeten GJ, de Koning HJ, National Evaluation Team for Breast Cancer Screening in Netherlands Study G (2013) Nation-wide data on screening performance during the transition to digital mammography: observations in 6 million screens. Eur J Cancer 49:3517–3525CrossRefPubMed van Luijt PA, Fracheboud J, Heijnsdijk EA, den Heeten GJ, de Koning HJ, National Evaluation Team for Breast Cancer Screening in Netherlands Study G (2013) Nation-wide data on screening performance during the transition to digital mammography: observations in 6 million screens. Eur J Cancer 49:3517–3525CrossRefPubMed
18.
Zurück zum Zitat Posso M, Puig T, Carles M, Rue M, Canelo-Aybar C, Bonfill X (2017) Effectiveness and cost-effectiveness of double reading in digital mammography screening: A systematic review and meta-analysis. Eur J Radiol 96:40–49CrossRefPubMed Posso M, Puig T, Carles M, Rue M, Canelo-Aybar C, Bonfill X (2017) Effectiveness and cost-effectiveness of double reading in digital mammography screening: A systematic review and meta-analysis. Eur J Radiol 96:40–49CrossRefPubMed
19.
Zurück zum Zitat Klompenhouwer EG, Weber RJ, Voogd AC et al (2015) Arbitration of discrepant BI-RADS 0 recalls by a third reader at screening mammography lowers recall rate but not the cancer detection rate and sensitivity at blinded and non-blinded double reading. Breast 24:601–607CrossRefPubMed Klompenhouwer EG, Weber RJ, Voogd AC et al (2015) Arbitration of discrepant BI-RADS 0 recalls by a third reader at screening mammography lowers recall rate but not the cancer detection rate and sensitivity at blinded and non-blinded double reading. Breast 24:601–607CrossRefPubMed
20.
Zurück zum Zitat Otten JD, Karssemeijer N, Hendriks JH et al (2005) Effect of recall rate on earlier screen detection of breast cancers based on the Dutch performance indicators. J Natl Cancer Inst 97:748–754CrossRefPubMed Otten JD, Karssemeijer N, Hendriks JH et al (2005) Effect of recall rate on earlier screen detection of breast cancers based on the Dutch performance indicators. J Natl Cancer Inst 97:748–754CrossRefPubMed
Metadaten
Titel
Incorporation of the technologist’s opinion for arbitration of discrepant assessments among radiologists at screening mammography
verfasst von
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
Publikationsdatum
05.05.2018
Verlag
Springer US
Erschienen in
Breast Cancer Research and Treatment / Ausgabe 1/2018
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-018-4800-4

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