Doralba Morrone1, Livia Giordano2, Franca Artuso3, Daniela Bernardi4, Chiara Fedato5, Alfonso Frigerio6, Daniela Giorgi7, Carlo Naldoni8, Gianni Saguatti9, Daniela Severi10, Mario Taffurelli11, Daniela Terribile12, Leonardo Ventura13, Lauro Bucchi14. 1. Senology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy. 2. Epidemiology Unit, Centre for Cancer Prevention (CPO), Turin, Italy. 3. Mammography Screening Unit, Centre for Cancer Prevention (CPO), Turin, Italy. 4. Clinical Senology and Mammography Screening Unit, Local Health Authority, Trento, Italy. 5. Regional Screening Coordinating Centre, Veneto Region, Venice, Italy. 6. Regional Reference Centre for Breast Cancer Screening, Turin, Italy. 7. Epidemiology Unit, Local Health Authority, Lucca, Italy. 8. Department of Health, Emilia-Romagna Region, Bologna, Italy. 9. Senology Unit, Local Health Authority, Bologna, Italy. 10. Cancer Prevention Unit, Local Health Authority, Forlì, Italy. 11. Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy. 12. Unité de Sénologie Chirurgicale, Hôpitaux Universitaires de Genève, Geneva, Switzerland. 13. Clinical and Descriptive Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy. 14. Romagna Cancer Registry, Romagna Cancer Institute (IRST) IRCCS, Meldola, Forlì, Italy. lauro.bucchi@irst.emr.it.
Abstract
PURPOSE: Screening mammogram reading volume (SMRV) and total (screening and clinical) mammogram reading volume (TMRV) per year are strongly associated with the radiologist's diagnostic performance in breast cancer screening. The current article reports the prevalence and correlates of a SMRV and a TMRV ≥5000 among Italian breast screening radiologists. MATERIALS AND METHODS: A questionnaire survey was carried out in 2013-2014 by the Italian Group for Mammography Screening (GISMa). The questionnaire included items of information for radiologist's experience-related characteristics and for facility-level factors supposedly associated with SMRV and TMRV. Multivariate analysis was performed using backward stepwise multiple logistic regression models. RESULTS: Data for 235 radiologists from 51 local screening programmes were received. Of the 222 radiologists who were eligible, 133 (59.9 %) reported a SMRV ≥5000 and 163 (73.4 %) a TMRV ≥5000. Multivariate factors positively associated with both characteristics included: the number of years of experience reading mammograms; the percentage of total working time dedicated to breast imaging and breast care; the participation in diagnostic assessment; and the availability of digital tomosynthesis at facility. Full-time dedication to breast imaging and breast care was associated with the highest odds ratio for a SMRV and a TMRV ≥5000, i.e. 11.80 and 46.74, respectively, versus a percentage of time ≤50 %. An early (<2000) year of implementation of the screening programme and the availability of vacuum-assisted biopsy at facility were associated with a SMRV and, respectively, a TMRV ≥5000. CONCLUSIONS: Increasing the proportion of radiologists with full-time dedication to breast imaging and breast care qualified as the most effective approach to improve SMRV and TMRV.
PURPOSE: Screening mammogram reading volume (SMRV) and total (screening and clinical) mammogram reading volume (TMRV) per year are strongly associated with the radiologist's diagnostic performance in breast cancer screening. The current article reports the prevalence and correlates of a SMRV and a TMRV ≥5000 among Italian breast screening radiologists. MATERIALS AND METHODS: A questionnaire survey was carried out in 2013-2014 by the Italian Group for Mammography Screening (GISMa). The questionnaire included items of information for radiologist's experience-related characteristics and for facility-level factors supposedly associated with SMRV and TMRV. Multivariate analysis was performed using backward stepwise multiple logistic regression models. RESULTS: Data for 235 radiologists from 51 local screening programmes were received. Of the 222 radiologists who were eligible, 133 (59.9 %) reported a SMRV ≥5000 and 163 (73.4 %) a TMRV ≥5000. Multivariate factors positively associated with both characteristics included: the number of years of experience reading mammograms; the percentage of total working time dedicated to breast imaging and breast care; the participation in diagnostic assessment; and the availability of digital tomosynthesis at facility. Full-time dedication to breast imaging and breast care was associated with the highest odds ratio for a SMRV and a TMRV ≥5000, i.e. 11.80 and 46.74, respectively, versus a percentage of time ≤50 %. An early (<2000) year of implementation of the screening programme and the availability of vacuum-assisted biopsy at facility were associated with a SMRV and, respectively, a TMRV ≥5000. CONCLUSIONS: Increasing the proportion of radiologists with full-time dedication to breast imaging and breast care qualified as the most effective approach to improve SMRV and TMRV.
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