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
Journal of the National Cancer
Institute, February 19, 2003