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Errors in Mammography Cannot be Solved Through Technology Alone

Mammography has been the frontline screening tool for breast cancer for decades. However, high error rates in the form of false negatives (FNs) and false positives (FPs) have persisted despite technological improvements. Radiologists still miss between 10% and 30% of cancers while 80% of woman recal...

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Autores principales: Ekpo, Ernest Usang, Alakhras, Maram, Brennan, Patrick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: West Asia Organization for Cancer Prevention 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980911/
https://www.ncbi.nlm.nih.gov/pubmed/29479948
http://dx.doi.org/10.22034/APJCP.2018.19.2.291
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author Ekpo, Ernest Usang
Alakhras, Maram
Brennan, Patrick
author_facet Ekpo, Ernest Usang
Alakhras, Maram
Brennan, Patrick
author_sort Ekpo, Ernest Usang
collection PubMed
description Mammography has been the frontline screening tool for breast cancer for decades. However, high error rates in the form of false negatives (FNs) and false positives (FPs) have persisted despite technological improvements. Radiologists still miss between 10% and 30% of cancers while 80% of woman recalled for additional views have normal outcomes, with 40% of biopsied lesions being benign. Research show that the majority of cancers missed is actually visible and looked at, but either go unnoticed or are deemed to be benign. Causal agents for these errors include human related characteristics resulting in contributory search, perception and decision-making behaviours. Technical, patient and lesion factors are also important relating to positioning, compression, patient size, breast density and presence of breast implants as well as the nature and subtype of the cancer itself, where features such as architectural distortion and triple-negative cancers remain challenging to detect on screening. A better understanding of these causal agents as well as the adoption of technological and educational interventions, which audits reader performance and provide immediate perceptual feedback, should help. This paper reviews the current status of our knowledge around error rates in mammography and explores the factors impacting it. It also presents potential solutions for maximizing diagnostic efficacy thus benefiting the millions of women who undergo this procedure each year.
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spelling pubmed-59809112018-06-07 Errors in Mammography Cannot be Solved Through Technology Alone Ekpo, Ernest Usang Alakhras, Maram Brennan, Patrick Asian Pac J Cancer Prev Review Mammography has been the frontline screening tool for breast cancer for decades. However, high error rates in the form of false negatives (FNs) and false positives (FPs) have persisted despite technological improvements. Radiologists still miss between 10% and 30% of cancers while 80% of woman recalled for additional views have normal outcomes, with 40% of biopsied lesions being benign. Research show that the majority of cancers missed is actually visible and looked at, but either go unnoticed or are deemed to be benign. Causal agents for these errors include human related characteristics resulting in contributory search, perception and decision-making behaviours. Technical, patient and lesion factors are also important relating to positioning, compression, patient size, breast density and presence of breast implants as well as the nature and subtype of the cancer itself, where features such as architectural distortion and triple-negative cancers remain challenging to detect on screening. A better understanding of these causal agents as well as the adoption of technological and educational interventions, which audits reader performance and provide immediate perceptual feedback, should help. This paper reviews the current status of our knowledge around error rates in mammography and explores the factors impacting it. It also presents potential solutions for maximizing diagnostic efficacy thus benefiting the millions of women who undergo this procedure each year. West Asia Organization for Cancer Prevention 2018 /pmc/articles/PMC5980911/ /pubmed/29479948 http://dx.doi.org/10.22034/APJCP.2018.19.2.291 Text en Copyright: © Asian Pacific Journal of Cancer Prevention http://creativecommons.org/licenses/BY-SA/4.0 This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
spellingShingle Review
Ekpo, Ernest Usang
Alakhras, Maram
Brennan, Patrick
Errors in Mammography Cannot be Solved Through Technology Alone
title Errors in Mammography Cannot be Solved Through Technology Alone
title_full Errors in Mammography Cannot be Solved Through Technology Alone
title_fullStr Errors in Mammography Cannot be Solved Through Technology Alone
title_full_unstemmed Errors in Mammography Cannot be Solved Through Technology Alone
title_short Errors in Mammography Cannot be Solved Through Technology Alone
title_sort errors in mammography cannot be solved through technology alone
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980911/
https://www.ncbi.nlm.nih.gov/pubmed/29479948
http://dx.doi.org/10.22034/APJCP.2018.19.2.291
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