Radiologist Training May Affect Accuracy of Mammogram Interpretation

 Behind the Cancer Headlines®

February 19, 2003 


A new study suggests that radiologist training and facility characteristics, rather than volume of mammograms read per year, are associated with accuracy in the interpretation of mammograms. The findings appear in the Journal of the National Cancer Institute

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 who were trained more recently interpreted screening mammograms much 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.  



Journal of the National Cancer Institute, February 19, 2003