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Rigshospitalet - en del af Københavns Universitetshospital
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Screening mammography: benefit of double reading by breast density

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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  • My von Euler-Chelpin
  • Martin Lillholm
  • George Napolitano
  • Ilse Vejborg
  • Mads Nielsen
  • Elsebeth Lynge
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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.

OriginalsprogEngelsk
TidsskriftBreast Cancer Research and Treatment
Vol/bind171
Udgave nummer3
Sider (fra-til)767-776
Antal sider10
ISSN0167-6806
DOI
StatusUdgivet - okt. 2018

ID: 55811632