Radiologist training may affect accuracy of mammogram interpretation

Past studies had found that higher reading volume was associated with increased accuracy in the interpretation of mammograms. Other studies had found that factors such as quality of feedback given to radiologists may account for differences in accuracy of mammographic interpretations. However, all of the studies were limited by either small sample size or narrow population of radiologists studied.

To clarify the relationship between reading volume and other factors in the accuracy of mammographic interpretations, Craig A. Beam, Ph.D., of the H. Lee Moffitt Cancer Center & Research Institute at the University of South Florida in Tampa, and his colleagues asked 110 U.S. radiologists to interpret screening mammograms from 148 randomly selected women in a controlled environment. The authors collected data about the participating radiologists and their affiliated facilities.

After controlling for other variables, the authors found that neither current reading volume (the number of mammograms read the year before the study) nor the number of years of reading mammograms were statistically significantly associated with accuracy. However, radiologists trained more recently interpreted screening mammograms statistically significantly more accurately than radiologists trained earlier.

In addition, facilities that performed more diagnostic breast imaging examinations and image-guided breast interventional procedures, those that were classified as a comprehensive breast diagnostic and/or screening center, and those that practiced double reading were also associated with increased accuracy of mammographic interpretations.

In an accompanying editorial, Joann G. Elmore, M.D., of the University of Washington School of Medicine, and her colleagues point out that experience is a multidimensional factor that cannot be fully described by a single measure, such as annual volume. "In light of these complex issues and conflicting results, additional studies are warranted," they write.

In the meantime, the editorialists suggest that women undergoing screening mammography go to the same facility and/or ensure that prior films are available for comparison. They add that menstruating women should time their mammographic examination during the first half of their menstrual cycle to ensure that they obtain the most accurate mammogram.

Contact: Andrea Brunais, H. Lee Moffitt Cancer Center, 813-632-1478; fax: 813-632-1380, [email protected]

Editorial: Susan Gregg-Hanson, Harborview Medical Center, 206-731-4097; fax: 206-731-8605, [email protected]

Beam CA, Conant EF, Sickles EA. Association of volume and volume-independent factors with accuracy in screening mammogram interpretation. J Natl Cancer Inst 2003;95:282�90.

Editorial: Elmore JG, Miglioretti DL, Carney PA. Does practice make perfect when interpreting mammography? Part II. J Natl Cancer Inst 2003;95:250�2.

Note: The Journal of the National Cancer Institute is published by Oxford University Press and is not affiliated with the National Cancer Institute. Attribution to the Journal of the National Cancer Institute is requested in all news coverage.