scholarly journals Independent Double Reading of Screening Mammograms

1995 ◽  
Vol 2 (2) ◽  
pp. 99-101 ◽  
Author(s):  
Stefano Ciatto ◽  
Marco Rosselli Del Turco ◽  
Doralba Morrone ◽  
Sandra Catarzi ◽  
Daniela Ambrogetti ◽  
...  
Keyword(s):  
Cancer Detection ◽  
Detection Rate ◽  
Recall Rate ◽  
Cancer Detection Rate ◽  
Diagnostic Assessment ◽  
Double Reading ◽  
Single Reading ◽  
The Mean ◽  
Screening Mammograms ◽  
The Cost

Objective — To evaluate the cost effectiveness of independent double reading of screening mammograms. Setting — Prospective study of 18817 women undergoing first or repeat screening in a population based programme in the Florence district. Methods — Mammograms were independently double read by experienced radiologists. Subjects with mammographic abnormalities reported by at least one reader were recalled for diagnostic assessment. The mean increase in recall rate, cancer detection rate, and screening costs attributable to double reading was calculated. Results — Eleven of 125 cancers were detected by only one reader. The mean increase in cancer detection rate attributable to double reading compared with single reading was 4·6% (95% confidence interval (CI) 1·1 to 8·9). From a total of 748 cases referred for diagnostic assessment, 196 subjects were referred by one reader only. The mean increase in referral rate attributable to double reading compared with single reading was 15·1% (CI 12·3 to 17·8). Double reading caused a marked increase in the cost for each woman screened −8·5% at the first screening and 6·2% at repeat screening and a more limited increase in the cost for each cancer detected −3·5% at the first screening and 2·7% at repeat screening. Cancers detected by only one screener were at an earlier stage than those detected by both screeners (P = 0·6, not significant). Conclusions — Independent double reading results in only a modest increase in the detection of cancers and therefore may not be cost effective.

Validity of process indicators of screening for breast cancer to predict mortality reduction

2005 ◽  
Vol 12 (1) ◽  
pp. 33-37 ◽  
Author(s):  
T Sarkeala ◽  
A Anttila ◽  
I Saarenmaa ◽  
M Hakama
Keyword(s):  
Breast Cancer ◽  
European Community ◽  
Cancer Detection ◽  
Detection Rate ◽  
Randomized Trials ◽  
Recall Rate ◽  
Cancer Detection Rate ◽  
Process Indicators ◽  
The Mean ◽  
Mean Compliance

The aim of the study was to empirically assess the acceptable levels of process indicators as described in the European Community Guidelines using materials from the mammography service screening programmes. The Finnish programme was evaluated for effectiveness with a prior estimateof 0.74 for RR in Finland and 0.81 in Helsinki. Hence, the Finnish programme was likely to be somewhat less effective in terms of reduction in mortality than implied on the basis of early randomized trials, but probably approaching the same level of effectiveness. Finland therefore providesbackground data on the applicability of the process indicators that are indicators of performance and surrogates for effectiveness. The performance data on 10 Finnish screening centres at subsequent screens were used. These centres invited 687,000 women aged 50–64 years in 1991–2000.The mean compliance was 93% and the corresponding recall rate was 2.3%. The benign to malignant biopsy ratio was 0.43:1. The average breast cancer detection rate was 0.36%, 2.1 compared with the background incidence. The proportion of screen-detected stage II+ cancers was 26%. Most, but notall, of these process indicators met the desirable reference values of the European Community. The specific criteria of the European Community on stage distribution, rates of screen-detected cancers by stage and detection rate to background incidence may need reconsideration.

Digital mammography in a screening programme and its implications for pathology: a comparative study

2010 ◽  
Vol 64 (3) ◽  
pp. 215-219 ◽  
Author(s):  
Linda Feeley ◽  
Donal Kiernan ◽  
Therese Mooney ◽  
Fidelma Flanagan ◽  
Gormlaith Hargaden ◽  
...  
Keyword(s):  
Cancer Detection ◽  
Digital Mammography ◽  
Detection Rate ◽  
Screening Programme ◽  
Ductal Carcinoma ◽  
Recall Rate ◽  
Primary Objective ◽  
Cancer Detection Rate ◽  
Detection Rates ◽  
Predictive Values

AimsMost studies comparing full-field digital mammography (FFDM) with conventional screen-film mammography (SFM) have been radiology-based. The pathological implications of FFDM have received little attention in the literature, especially in the context of screening programmes. The primary objective of this retrospective study is to compare FFDM with SFM in a population-based screening programme with regard to a number of pathological parameters.MethodsDuring the study period, 107 818 women underwent screening mammograms with almost equal numbers obtained with each technique (49.9% with SFM vs 50.1% with FFDM). We compared SFM with FFDM using the following parameters: recall rate, diagnostic core biopsy rate, cancer detection rates, B3 rate, B4 rate, preoperative diagnostic rate for malignancy, positive predictive values and tumour characteristics.ResultsThe recall rate was significantly higher with FFDM (4.21% vs 3.52%, p<0.0001). The overall cancer detection rate of 7.2 per 1000 women screened with FFDM was also significantly higher than the rate of 6.2 per 1000 women screened with SFM (p=0.04). The B3 rate in the SFM group was 1.3 per 1000 women screened versus 2.5 per 1000 women screened in the FFDM group (p<0.001). The recall rate and cancer detection rates (overall, invasive and pure ductal carcinoma in situ) were all significantly higher with FFDM for lesions presenting as microcalcifications.ConclusionsThe higher cancer detection rate with FFDM in this study was due to improved detection of microcalcifications. However, this was achieved at the cost of a higher recall rate and a higher B3 rate, indicating that overtreatment may be problematic with digital mammography.

scholarly journals The role of arbitration of discordant reports at double reading of screening mammograms

2005 ◽  
Vol 12 (3) ◽  
pp. 125-127 ◽  
Author(s):  
S Ciatto ◽  
D Ambrogetti ◽  
G Risso ◽  
S Catarzi ◽  
D Morrone ◽  
...  
Keyword(s):  
Cancer Detection ◽  
Screening Programme ◽  
False Negative ◽  
Cancer Detection Rate ◽  
Routine Procedure ◽  
Double Reading ◽  
Referral Rates ◽  
Relative Decrease ◽  
Screening Mammograms

Objective: To asses the effectiveness of arbitration of discordant double readings in mammography screening. Design: A retrospective study of 1217 consecutive arbitrations. Setting: A subset of discordant double readings from the Florence screening programme underwent arbitration by a third reader. Results: Positive arbitration of 1217 discordant double readings prompted assessment in 476 cases (39.2%), detecting 30 cancers (6.3%). Of 741 negative arbitrations (60.8%), 311 have been followed up thus far, and two cancers (0.64%) occurred in the site previously suspected at one of the two independent readings. Arbitration had a sensitivity of 86.3% and a negative predictive value of 99.3%. Arbitration reduced the overall referral rates from 3.82% to 2.59% (relative decrease 32.1%). Due to false-negative arbitration, cancers detected per 1000 women screened would decrease from 4.58 to 4.50 (relative decrease 1.7%). For every cancer missed due to false-negative arbitration, 151 unnecessary recalls and €21,248 would have been saved, whereas the saved cost per screened woman due to arbitration was €1.72. Discussion: Arbitration of discordant double reading would substantially reduce referral rates with a limited reduction in cancer detection rate, and may be recommended as a routine procedure. Greater benefit from arbitration might be expected in the presence of high referral rates at independent double reading, a common scenario in a newly implemented service screening.

scholarly journals Increased Cancer Detection Rate and Variations in the Recall Rate Resulting from Implementation of 3D Digital Breast Tomosynthesis into a Population-based Screening Program

Radiology ◽  
2016 ◽  
Vol 278 (3) ◽  
pp. 698-706 ◽  
Author(s):  
Richard E. Sharpe ◽  
Shambavi Venkataraman ◽  
Jordana Phillips ◽  
Vandana Dialani ◽  
Valerie J. Fein-Zachary ◽  
...  
Keyword(s):  
Cancer Detection ◽  
Detection Rate ◽  
Screening Program ◽  
Digital Breast Tomosynthesis ◽  
Recall Rate ◽  
Population Based ◽  
Cancer Detection Rate ◽  
Breast Tomosynthesis

scholarly journals Transrectal versus transperineal 14-core prostate biopsy in detection of prostate cancer: A comparative evaluation at the same Institution

2014 ◽  
Vol 86 (4) ◽  
pp. 284 ◽  
Author(s):  
Maria Angela Cerruto ◽  
Fabio Vianello ◽  
Carolina D’Elia ◽  
Walter Artibani ◽  
Giovanni Novella
Keyword(s):  
Cancer Detection ◽  
Prostate Biopsy ◽  
Detection Rate ◽  
Cancer Detection Rate ◽  
Controlled Study ◽  
Pain Level ◽  
Prostatic Biopsy ◽  
Detection Rates ◽  
The Mean ◽  
Prospective Controlled Study

Background: The ideal bioptic strategy for CaP detection is still to be completely defined. The aim of our study is to compare transperineal (TP) and transrectal (TR) approaches, in a 14-core initial prostate biopsy for CaP detection. Material and methods: A prospective controlled study was conducted enrolling 108 consecutive patients with a PSA level greater than 4 ng/mL and/or an abnormal DRE. TR versus TP 14-core initial prostatic biopsies were performed on 54 and 54 patients, respectively, with a randomisation ratio of 1:1. Results: The cancer detection rates were 46.29 (25 out of 54 patients), and 44.44% (24 out of 54 patients), respectively, using the TR or the TP approach (p = 0.846). The overall cancer core rate was significantly higher when the TP approach was used: 21.43% (162 out of 756 cores) and 16.79% (127 out of 756 cores), with the TP and the TR approach, respectively (p = 0.022). The cores were significantly longer performing TP approach: at the site “1” (14.92 versus 12.97 mm, p = 0.02); at “5” (15.53 versus 13.69 mm, p = 0.037); at “7” (15.06 versus 12.86 mm, p = 0.001); at “9” (14.92 versus 13.38 mm, p = 0.038); at “11” (16.32 versus 12.31 mm, p = 0.0001); at “12” (15.14 versus 12.19 mm, p = 0.0001); at “13” (17.49 versus 13.98 mm, p = 0.0001); at “14” (16.77 versus 13.36 mm, p = 0.0001). As to the biopsy related pain, the mean pain level perceived by patients during the TR approach was 1.56 ± 1.73 versus 1.42 ± 1.37 registered during TP approach (p = 0.591). Conclusions: No significant differences were found in cancer detection rate, cancer core rate between TP and TR approaches for prostatic biopsy. Even in terms of complication rate or pain level, it cannot be concluded that one procedure is superior to the other one. Apparently, strictly following our protocol, TP approach seems to offer a better sampling at the level of the apex and the TZ, however without adding any significant advantage in terms of overall cancer detection rate.

scholarly journals Increased Cancer Detection Rate and Variations in the Recall Rate Resulting from Implementation of 3D Digital Breast Tomosynthesis into a Population-based Screening Program

Radiology ◽  
2016 ◽  
Vol 280 (3) ◽  
pp. 981-981 ◽  
Author(s):  
Richard E. Sharpe ◽  
Shambavi Venkataraman ◽  
Jordana Phillips ◽  
Vandana Dialani ◽  
Valerie J. Fein-Zachary ◽  
...  
Keyword(s):  
Cancer Detection ◽  
Detection Rate ◽  
Screening Program ◽  
Digital Breast Tomosynthesis ◽  
Recall Rate ◽  
Population Based ◽  
Cancer Detection Rate ◽  
Breast Tomosynthesis

scholarly journals Is full field digital mammography equivalent in performance to screen film mammography? UK perspective

2014 ◽  
Vol 1 (2) ◽  
pp. 106
Author(s):  
Gaurav J Bansal ◽  
Iain Lyburn ◽  
Thomas Jones
Keyword(s):  
Cancer Detection ◽  
Detection Rate ◽  
Recall Rate ◽  
Cancer Detection Rate ◽  
Invasive Cancer ◽  
High Grade ◽  
Full Field ◽  
Non Invasive ◽  
Full Field Digital Mammography ◽  
Significant Difference

Aim: The purpose of this project was to compare the performance of full-field digital imaging (FFDM) with screen film mammography (SFM). Methods: Data from 24,876 and 32,142 women in SFM and FFDM group respectively was collected retrospectively and comparison was made of the recall rate, breast cancer detection rate and positive predictive value (PPV) for the recalls for the two screening modalities, screen film mammography (SFM) and full field digital mammography (FFDM). Difference in radiologic characteristics of the tumours and tumour type (Ductal carcinoma in situ {DCIS} versus invasive) was also evaluated. Statistical software SPSS (PASW18) was used for data analysis with Pearson chi-square and Mann-Whitney-U test used to compare the two groups. A p value of less that 0.05 was considered to indicate a statistically significant difference. Results: In the year 2008-2009(SFM group), there was a recall rate of 4.5% and a cancer detection rate of 7.5/1000 in the recalled group. For the year 2009-2010 (FFDM group), there was a recall rate of 4.9% and cancer detection rate of 8.8/1000 in the recalled group. There was no statistically significant difference between the recall rate and cancer detection rate between the two groups (p = 0.157). Within the digital group, there was 88(88%) invasive cancer and 12(12%) non-invasive cancer, whereas within the analogue group, there were 74 (92.5%) invasive cancer and 6(7.5%) non-invasive cancer. Most of the non-invasive cancers in the FFDM group were high grade with only one mixed low-intermediate grade. In the analogue group, 50% were high grade, rest being low or intermediate grade. The histological distribution of cancer between two groups was not found to be statistically significant (p = 0.108). Conclusion: Our study demonstrated FFDM was similar to SFM in terms of cancer detection rate, recall rate and positive predictive value for recalls. 

scholarly journals Efficiency of cancer detection during routine repeat (incident) mammographic screening: two versus one view mammography

1998 ◽  
Vol 5 (3) ◽  
pp. 141-145 ◽  
Author(s):  
R G Blanks ◽  
R M Given-Wilson ◽  
S M Moss
Keyword(s):  
Cancer Detection ◽  
Detection Rate ◽  
Controlled Trial ◽  
Cancer Detection Rate ◽  
Reliable Estimate ◽  
Oblique View ◽  
Test Sets ◽  
The Mean ◽  
Incident Cases

Objective To examine the influence of one view versus two view mammography on cancer detection and recall for further investigation of women attending incident (subsequent) screening. Setting All cancers (invasive and in situ) detected as incident cases during the second screening round (January 1994 to January 1997) at the South West London Breast Screening Service were used. This service uses two view mammography and double reading, with arbitration by a third or further readers for all screens. Methods Mammograms of cases were mixed with those of controls in a 1:2 ratio in nine test sets; each set was read independently by three film readers. Fourteen readers, each reading from one to four test sets, took part in the study. Initially, the oblique view only was read, then the craniocaudal view was read in addition. Previous films were available to the readers. Data on abnormalities noted on the films and probability of recall were recorded and analysed. Results 10 of the 14 readers obtained increased sensitivity using two views (p=0.04), for two readers there was no difference, and for two readers sensitivity decreased. The mean sensitivity increase was 6.1% (p=0.01). The overall increase in sensitivity from all readings of invasive cancers was 8.9%, with no increase seen for in situ cancers. 11 of the 14 readers obtained an increase in specificity (p=0.006), two readers showed no increase, and the specificity for one reader was decreased. The mean increase in specificity using two views was 5.7% (p=0.006). Conclusion This study showed an increase of 8.9% in sensitivity for the detection of invasive cancers when two views are used at incident screening, with a ratio of two control mammograms for every case. This is equivalent to a sample from population screening with a cancer detection rate of 333 per 1000. Such a study is considered to be likely to underestimate the benefit of two views in screening under non-test conditions where the cancer detection rate is of the order of five per 1000. The use of two view mammography for the detection of in situ cancers showed no increased benefit. A randomised controlled trial is needed to obtain a reliable estimate of the increase in cancer detection rate for incident screening in normal populations.

Comparison of Radiographer/Radiologist Double Film Reading with Single Reading in Breast Cancer Screening

1996 ◽  
Vol 3 (1) ◽  
pp. 18-22 ◽  
Author(s):  
Regina Pauli ◽  
Sean Hammond ◽  
Julie Cooke ◽  
Janet Ansell
Keyword(s):  
Decision Model ◽  
Screening Mammography ◽  
Double Reading ◽  
West Region ◽  
Single Reading ◽  
Screening Performance ◽  
Lower Specificity ◽  
Screening Mammograms ◽  
Film Reading ◽  
The Cost

Objectives— To assess the efficacy of dual film reading in screening mammography with a suitably trained radiographer as the second reader and to determine a suitable decision model for radiographer/radiologist double reading. Setting— Three breast screening centres in South Thames (West) region. Methods— Seven radiographers with prior film reading training double read 17 202 screening mammograms with a radiologist. Screening performance of radiographers and radiologists was assessed taking into account interval cancers. The efficacy of radiographer/radiologist double reading was assessed in terms of changes in sensitivity and specificity compared with radiologist single reading. Results— Radiographers yielded equivalent sensitivity but lower specificity than radiologist film readers. The effect of double reading between radiographer/radiologist pairs was an increase in sensitivity of 6.4%, which was achieved at the cost of a 0.6% decrease in specificity. This was reached by a decision system involving radiologists' review of radiographer queries and recall classifications. If all radiographer queries were recalled a large increase in sensitivity would be counterbalanced by an equally large decrease in specificity. Conclusions— Radiographer/radiologist double reading resulted in similar increases in sensitivity as those previously reported in radiologist double reading studies. Radiologist review of radiographer reported abnormalities is a suitable means by which to limit excess recall.

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