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Screening mammography: benefit of double reading by breast density

PURPOSE: The currently recommended double reading of all screening mammography examinations is an economic burden for screening programs. The sensitivity of screening is higher for women with low breast density than for women with high density. One may therefore ask whether single reading could repl...

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Autores principales: Euler-Chelpin, My von, Lillholm, Martin, Napolitano, George, Vejborg, Ilse, Nielsen, Mads, Lynge, Elsebeth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6133172/
https://www.ncbi.nlm.nih.gov/pubmed/29974357
http://dx.doi.org/10.1007/s10549-018-4864-1
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author Euler-Chelpin, My von
Lillholm, Martin
Napolitano, George
Vejborg, Ilse
Nielsen, Mads
Lynge, Elsebeth
author_facet Euler-Chelpin, My von
Lillholm, Martin
Napolitano, George
Vejborg, Ilse
Nielsen, Mads
Lynge, Elsebeth
author_sort Euler-Chelpin, My von
collection PubMed
description PURPOSE: The currently recommended double reading of all screening mammography examinations is an economic burden for screening programs. The sensitivity of screening is higher for women with low breast density than for women with high density. One may therefore ask whether single reading could replace double reading at least for women with low density. We addressed this question using data from a screening program where the radiologists coded their readings independently. METHODS: Data include all screening mammography examinations in the Capital Region of Denmark from 1 November 2012 to 31 December 2013. Outcome of screening was assessed by linkage to the Danish Pathology Register. We calculated sensitivity, specificity, number of interval cancers, and false positive-tests per 1000 screened women by both single reader and consensus BI-RADS density code. RESULTS: In total 54,808 women were included. The overall sensitivity of double reading was 72%, specificity was 97.6%, 3 women per 1000 screened experienced an interval cancer, and 24 a false-positive test. Across all BI-RADS density codes, single reading consistently decreased sensitivity as compared with consensus reading. The same was true for specificity, apart from results across BI-RADS density codes set by reader 2. CONCLUSIONS: Single reading decreased sensitivity as compared with double reading across all BI-RADS density codes. This included results based on consensus BI-RADS density codes. This means that replacement of double with single reading would have negative consequences for the screened women, even if density could be assessed automatically calibrated to the usual consensus level.
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spelling pubmed-61331722018-09-14 Screening mammography: benefit of double reading by breast density Euler-Chelpin, My von Lillholm, Martin Napolitano, George Vejborg, Ilse Nielsen, Mads Lynge, Elsebeth Breast Cancer Res Treat Epidemiology PURPOSE: The currently recommended double reading of all screening mammography examinations is an economic burden for screening programs. The sensitivity of screening is higher for women with low breast density than for women with high density. One may therefore ask whether single reading could replace double reading at least for women with low density. We addressed this question using data from a screening program where the radiologists coded their readings independently. METHODS: Data include all screening mammography examinations in the Capital Region of Denmark from 1 November 2012 to 31 December 2013. Outcome of screening was assessed by linkage to the Danish Pathology Register. We calculated sensitivity, specificity, number of interval cancers, and false positive-tests per 1000 screened women by both single reader and consensus BI-RADS density code. RESULTS: In total 54,808 women were included. The overall sensitivity of double reading was 72%, specificity was 97.6%, 3 women per 1000 screened experienced an interval cancer, and 24 a false-positive test. Across all BI-RADS density codes, single reading consistently decreased sensitivity as compared with consensus reading. The same was true for specificity, apart from results across BI-RADS density codes set by reader 2. CONCLUSIONS: Single reading decreased sensitivity as compared with double reading across all BI-RADS density codes. This included results based on consensus BI-RADS density codes. This means that replacement of double with single reading would have negative consequences for the screened women, even if density could be assessed automatically calibrated to the usual consensus level. Springer US 2018-07-04 2018 /pmc/articles/PMC6133172/ /pubmed/29974357 http://dx.doi.org/10.1007/s10549-018-4864-1 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Epidemiology
Euler-Chelpin, My von
Lillholm, Martin
Napolitano, George
Vejborg, Ilse
Nielsen, Mads
Lynge, Elsebeth
Screening mammography: benefit of double reading by breast density
title Screening mammography: benefit of double reading by breast density
title_full Screening mammography: benefit of double reading by breast density
title_fullStr Screening mammography: benefit of double reading by breast density
title_full_unstemmed Screening mammography: benefit of double reading by breast density
title_short Screening mammography: benefit of double reading by breast density
title_sort screening mammography: benefit of double reading by breast density
topic Epidemiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6133172/
https://www.ncbi.nlm.nih.gov/pubmed/29974357
http://dx.doi.org/10.1007/s10549-018-4864-1
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