Zoey Zy Ang1,2, Mohammad A Rawashdeh1,3, Rob Heard4, Patrick C Brennan1, Warwick Lee1, Sarah J Lewis1. 1. Medical Imaging Optimisation and Perception Group (MIOPeG), Faculty of Health Sciences, Discipline of Medical Radiation Sciences, The University of Sydney, Lidcombe, New South Wales, Australia. 2. National Healthcare Group Diagnostics (NHGD), Singapore City, Singapore. 3. Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan. 4. Health Systems and Global Populations Research Group, Faculty of Health Sciences, Discipline of Behavioural and Social Sciences in Health, The University of Sydney, Lidcombe, New South Wales, Australia.
Abstract
INTRODUCTION: To investigate how breast screen readers classify normal screening cases using descriptors of normal mammographic features and to assess test cases for suitability for a single reading strategy. METHODS: Fifteen breast screen readers interpreted a test set of 29 normal screening cases and classified them by firstly rating their perceived difficulty to reach a 'normal' decision, secondly identifying the cases' salient normal mammographic features and thirdly assessing the cases' suitability for a single reading strategy. RESULTS: The relationship between the perceived difficulty in making 'normal' decisions and the normal mammographic features was investigated. Regular ductal pattern (Tb = -0.439, P = 0.001), uniform density (Tb = -0.527, P < 0.001), non-dense breasts (Tb = -0.736, P < 0.001), symmetrical mammographic features (Tb = -0.474, P = 0.001) and overlapped density (Tb = 0.630, P < 0.001) had a moderate to strong correlation with the difficulty to make 'normal' decisions. Cases with regular ductal pattern (Tb = 0.447, P = 0.002), uniform density (Tb = 0.550, P < 0.001), non-dense breasts (Tb = 0.748, P < 0.001) and symmetrical mammographic features (Tb = 0.460, P = 0.001) were considered to be more suitable for single reading, whereas cases with overlapped density were not (Tb = -0.679, P < 0.001). CONCLUSION: The findings suggest that perceived mammographic breast density has a major influence on the difficulty for readers to classify cases as normal and hence their suitability for single reading.
INTRODUCTION: To investigate how breast screen readers classify normal screening cases using descriptors of normal mammographic features and to assess test cases for suitability for a single reading strategy. METHODS: Fifteen breast screen readers interpreted a test set of 29 normal screening cases and classified them by firstly rating their perceived difficulty to reach a 'normal' decision, secondly identifying the cases' salient normal mammographic features and thirdly assessing the cases' suitability for a single reading strategy. RESULTS: The relationship between the perceived difficulty in making 'normal' decisions and the normal mammographic features was investigated. Regular ductal pattern (Tb = -0.439, P = 0.001), uniform density (Tb = -0.527, P < 0.001), non-dense breasts (Tb = -0.736, P < 0.001), symmetrical mammographic features (Tb = -0.474, P = 0.001) and overlapped density (Tb = 0.630, P < 0.001) had a moderate to strong correlation with the difficulty to make 'normal' decisions. Cases with regular ductal pattern (Tb = 0.447, P = 0.002), uniform density (Tb = 0.550, P < 0.001), non-dense breasts (Tb = 0.748, P < 0.001) and symmetrical mammographic features (Tb = 0.460, P = 0.001) were considered to be more suitable for single reading, whereas cases with overlapped density were not (Tb = -0.679, P < 0.001). CONCLUSION: The findings suggest that perceived mammographic breast density has a major influence on the difficulty for readers to classify cases as normal and hence their suitability for single reading.