S P Poplack1, A N Tosteson, M R Grove, W A Wells, P A Carney. 1. Departments of Radiology, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, HB 7999, Lebanon, NH 03756, USA. steven.p.poplack@hitchcock.org
Abstract
PURPOSE: To describe measures of mammography performance in a geographically defined population and evaluate the interpreter's use of the Breast Imaging Reporting and Data System (BI-RADS). MATERIALS AND METHODS: Mammographic data from 47,651 screening and 6,152 diagnostic examinations from November 1, 1996, to October 31, 1997, were linked to 1,572 pathologic results. Mammographic outcomes were based on BI-RADS assessments and recommendations reported by the interpreting radiologist. The consistency of BI-RADS recommendations was evaluated. RESULTS: Screening mammography had a sensitivity of 72.4% (95% CI: 66.4%, 78.4%), specificity of 97.3% (95% CI: 97.25%, 97.4%), and positive predictive value of 10.6% (95% CI: 9.1%, 12.2%). Diagnostic mammography had higher sensitivity, 78.1% (95% CI: 71.9%, 84.3%); lower specificity, 89.3% (95% CI: 88.5%, 90.1%); and better positive predictive value, 17.1% (95% CI: 14.5%, 19.8%). The cancer detection rate with screening mammography was 3.3 per 1,000 women, with a biopsy yield of 22.4%, whereas the interval cancer rate was 1. 2 per 1,000. Nearly 80% of screening-detected invasive malignancies were node negative. The recall rate for screening mammography was 8. 3%. Ultrasonography was used in 3.5% of screening and 17.5% of diagnostic examinations. BI-RADS recommendations were generally consistent, except for probably benign assessments. CONCLUSION: The sensitivity of screening mammography in this population-based sample is lower than expected, although other performance indicators are commendable. BI-RADS "probably benign" assessments are commonly misused.
PURPOSE: To describe measures of mammography performance in a geographically defined population and evaluate the interpreter's use of the Breast Imaging Reporting and Data System (BI-RADS). MATERIALS AND METHODS: Mammographic data from 47,651 screening and 6,152 diagnostic examinations from November 1, 1996, to October 31, 1997, were linked to 1,572 pathologic results. Mammographic outcomes were based on BI-RADS assessments and recommendations reported by the interpreting radiologist. The consistency of BI-RADS recommendations was evaluated. RESULTS: Screening mammography had a sensitivity of 72.4% (95% CI: 66.4%, 78.4%), specificity of 97.3% (95% CI: 97.25%, 97.4%), and positive predictive value of 10.6% (95% CI: 9.1%, 12.2%). Diagnostic mammography had higher sensitivity, 78.1% (95% CI: 71.9%, 84.3%); lower specificity, 89.3% (95% CI: 88.5%, 90.1%); and better positive predictive value, 17.1% (95% CI: 14.5%, 19.8%). The cancer detection rate with screening mammography was 3.3 per 1,000 women, with a biopsy yield of 22.4%, whereas the interval cancer rate was 1. 2 per 1,000. Nearly 80% of screening-detected invasive malignancies were node negative. The recall rate for screening mammography was 8. 3%. Ultrasonography was used in 3.5% of screening and 17.5% of diagnostic examinations. BI-RADS recommendations were generally consistent, except for probably benign assessments. CONCLUSION: The sensitivity of screening mammography in this population-based sample is lower than expected, although other performance indicators are commendable. BI-RADS "probably benign" assessments are commonly misused.
Authors: F Collettini; J C Martin; F Diekmann; E Fallenberg; F Engelken; S Ponder; T J Kroencke; B Hamm; A Poellinger Journal: Eur Radiol Date: 2011-09-27 Impact factor: 5.315
Authors: R Edward Hendrick; Gary R Cutter; Eric A Berns; Connie Nakano; Joseph Egger; Patricia A Carney; Linn Abraham; Stephen H Taplin; Carl J D'Orsi; William Barlow; Joann G Elmore Journal: AJR Am J Roentgenol Date: 2005-02 Impact factor: 3.959
Authors: Paul M Meaney; Margaret W Fanning; Timothy Raynolds; Colleen J Fox; Qianqian Fang; Christine A Kogel; Steven P Poplack; Keith D Paulsen Journal: Acad Radiol Date: 2007-02 Impact factor: 3.173