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Diagnostic Mammogram Readings Vary by Radiologist
Date:12/11/2007

mes higher with those images than in screening mammograms, the study authors said.

For the study, the researchers looked at the records of 123 radiologists who had collectively interpreted 35,895 diagnostic mammograms at 72 U.S. facilities.

Close to 80 percent of breast cancers were diagnosed correctly. But sensitivity -- or the ability to accurately detect cancer -- ranged from 27 percent to 100 percent for different radiologists. False-positives (biopsies performed when there was no cancer) ranged from zero to 16 percent.

But 4.3 percent of women who had no cancer were tentatively told they had the disease, based on the mammogram (i.e. they received a false-positive reading).

The strongest factor linked to better accuracy was if the radiologist was affiliated with an academic medical center. Such radiologists were correct 88 percent of the time, compared to 76 percent for other radiologists. Radiologists at academic institutions were also less likely to report false-positive findings.

But the study results have to be taken with a grain of salt, the authors said, because only seven radiologists affiliated with academic institutions were represented in the study. This is more or less in keeping with the "real world," where academic radiologists interpret only 6.5 percent of mammograms across the nation, the authors said.

Radiologists who spent 20 percent or more of their time on breast imaging were more accurate than those who spent less time on breast imaging -- 80 percent versus 70 percent.

Interestingly, more experienced radiologists were less likely to recommend biopsies, but they missed more cancers than those with less experience, the study authors said.

"Radiologists who had been in practice longer had a lower threshold for recalling women for biopsies," Migliorettii said. "They had fewer false-positives but lower sensitivity, meaning they missed more cancers."

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