Mammogram Accuracy may be Affected by Timing of Training of Radiologist

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According to a recent article published in the Journal of the National Cancer Institute, more recently trained radiologists may provide more accurate readings of mammograms.

Breast cancer is a common malignancy in women, with over 200,000 cases diagnosed annually in the United States. Since breast cancer is highly curable when detected in early stages and may become incurable at later stages, women over the age of 40 are recommended to undergo an annual mammogram to screen for early-stage breast cancer. Mammography relies on the interpretation of a radiologist to determine if a suspicious mass is present in the breast and if this mass should undergo a biopsy. Previous studies have indicated that radiologists who read a higher volume of mammograms per year have been associated with improved cancer detection rates. However, a recent study suggests that the volume of mammograms read may not affect the accuracy, but the timing of training of radiologists may have a more profound effect on obtaining accurate results of mammography reading.

Researchers from the Lee Moffitt Cancer Center and Research Institute conducted a clinical study involving many variables to determine factors that may affect outcomes of mammography readings. This study included 110 U.S. radiologists who were asked to interpret mammographies from 148 women. The only variables that significantly affected the accuracy of reading mammographies were the timing of training of radiologists and the type of facility at which they worked.

Radiologists who had been trained more recently were significantly more accurate in their mammography readings. The volume of mammograms read annually or the number of years a radiologist had been reading mammograms did not affect accuracy. In addition, facilities in which radiologists practiced double reading, 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 were also associated with increased accuracy of mammographic interpretations.

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According to this study, the more recent a radiologist has been trained and the type of facility in which the mammogram is being read are independent variables that appear to affect the accuracy of the reading. However, researchers caution that more studies need to be performed in order to verify this finding. Researchers also advise women to have their mammograms performed at the same institution so radiologists can compare prior mammograms, or have their prior films sent to the present facility at which they will receive a mammogram. Furthermore, menstruating women should time their mammograms during the first half of their menstrual cycle in order to obtain more accurate readings. All women should speak with their physician about the risks and benefits of screening mammography.

References:

Beam C, Conant E, Sickles E. Association of Volume and Volume-Independent Factors With Accuracy in Screening Mammogram Interpretation. Journal of the National Cancer Institute. 2003;95:282-290.

Elmore J, Miglioretti D, Carney P. Does Practice Make Perfect When Interpreting Mammography? Part II. Journal of the National Cancer Institute. 2003;45:250-252.