Effect of Previous Benign Breast Biopsy on the Interpretive Performance of Subsequent Screening Mammography

Taplin, Stephen H.; Abraham, Linn; Geller, Berta M.; Yankaskas, Bonnie C.; Buist, Diana S.M.; Smith‐Bindman, Rebecca; Lehman, Constance D.; Weaver, Donald L.; Carney, Patricia A.; Barlow, William E.

doi:10.1093/jnci/djq233

Cited by 17 publications

(12 citation statements)

References 29 publications

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“…For women with a history of breast biopsy, screening mammograms are more likely to have lower specificity [21], a finding that we also found for both types of diagnostic mammograms. Given that cancer yield for biopsies is about 25% in the United States compared with 50–75% in Europe [22], this study reinforces the need to reduce the frequency of unnecessary benign breast biopsies, because women in the United States are at higher risk of a false-positive result compared with women in Europe.…”

Section: Discussionsupporting

confidence: 53%

Patient and Radiologist Characteristics Associated With Accuracy of Two Types of Diagnostic Mammograms

Jackson

Abraham

Miglioretti

et al. 2015

American Journal of Roentgenology

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Objective Earlier studies of diagnostic mammography found wide unexplained variability in accuracy among radiologists. We assessed patient and radiologist characteristics associated with the interpretive performance of two types of diagnostic mammography. Materials and Methods Radiologists interpreting mammograms in seven regions of the United States were invited to participate in a survey that collected information on their demographics, practice setting, breast imaging experience, and self-reported interpretive volume. Survey data from 244 radiologists were linked to data on 274,401 diagnostic mammograms performed for additional evaluation of a recent abnormal screening mammogram or to evaluate a breast problem, between 1998 and 2008. These data were also linked to patients' risk factors and follow-up data on breast cancer. We measured interpretive performance by false-positive rate, sensitivity, and AUC. Using logistic regression, we evaluated patient and radiologist characteristics associated with false-positive rate and sensitivity for each diagnostic mammogram type. Results Mammograms performed for additional evaluation of a recent mammogram had an overall false-positive rate of 11.9%, sensitivity of 90.2%, and AUC of 0.894; examinations done to evaluate a breast problem had an overall false-positive rate of 7.6%, sensitivity of 83.9%, and AUC of 0.871. Multiple patient characteristics were associated with measures of interpretive performance, and radiologist academic affiliation was associated with higher sensitivity for both indications for diagnostic mammograms. Conclusion These results indicate the potential for improved radiologist training, using evaluation of their own performance relative to best practices, and for improved clinical outcomes with health care system changes to maximize access to diagnostic mammography interpretation in academic settings.

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Section: Discussionsupporting

confidence: 53%

Patient and Radiologist Characteristics Associated With Accuracy of Two Types of Diagnostic Mammograms

Jackson

Abraham

Miglioretti

et al. 2015

American Journal of Roentgenology

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“…False-positive (FP) recalls for additional imaging after screening mammography occur for 14% of women at first screening and for 8% at subsequent exams (2, 6), causing many women inconvenience and anxiety. Recommendations for fine needle aspiration or surgical biopsy after screening mammography are less common (2) but have more severe consequences (7, 8). …”

Section: Introductionmentioning

confidence: 99%

Cumulative Probability of False-Positive Recall or Biopsy Recommendation After 10 Years of Screening Mammography

Hubbard¹,

Kerlikowske²,

Flowers³

et al. 2011

Ann Intern Med

375

207

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Background False-positive mammography results are common. Biennial screening may decrease the cumulative probability of false-positive results across many years of repeat screening but could also delay cancer diagnosis. Objective To compare the cumulative probability of false-positive results and the stage distribution of incident breast cancer after 10 years of annual or biennial screening mammography. Design Prospective cohort. Setting Seven mammography registries in the National Cancer Institute–funded Breast Cancer Surveillance Consortium. Participants 169,456 women who received a first screening mammogram at age 40–59 between 1994 and 2006 and 4,492 women with an incident invasive breast cancer diagnosed between 1996 and 2006. Measurements False-positive recalls and biopsy recommendations; stage distribution of incident breast cancer. Results False-positive recall probability was 16.3% at first and 9.6% at subsequent mammography. False-positive biopsy recommendation probability was 2.5% at first and 1.0% at subsequent examinations. Availability of comparison films halved the odds of a false-positive recall (adjusted OR 0.50 (CI 0.45, 0.56)). When screening began at age 40, the cumulative probability of a woman receiving at least one false-positive recall after 10 years was 61.3% (95% CI, 59.4% to 63.1%) with annual and 41.6% (CI, 40.6% to 42.5%) with biennial screening. Cumulative probability of false-positive biopsy recommendation was 7.0% (CI, 6.1% to 7.8%) with annual and 4.8% (CI, 4.4% to 5.2%) with biennial screening. Estimates were comparable when screening began at age 50. We observed a non-statistically significant increase in the proportion of late-stage cancers with biennial compared to annual screening (absolute increase 3.3% (CI −1.1, 7.8) age 40–49, 2.3% (CI −1.0, 5.7) age 50–59) among a population of women with incident breast cancer. Limitations Few women underwent screening over the entire 10 year period. Radiologist characteristics influence recall rates and were unavailable. Most mammograms were film rather than digital exams. Incident cancers were analyzed in a small population of women who developed cancer. Conclusions After 10 years of annual screening, more than half of women will receive at least one false-positive recall, and 7–9% will receive a false-positive biopsy recommendation. Biennial screening appears to reduce the cumulative probability of false-positive results after 10 years but may be associated with a small absolute increase in the probability of being diagnosed with late stage cancer.

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“…False-positive (FP) recalls for additional imaging after screening mammography occur for 14% of women at first screening and for 8% at subsequent exams (2,6), causing many women inconvenience and anxiety. Recommendations for fine needle aspiration or surgical biopsy after screening mammography are less common (2) but have more severe consequences (7,8).…”

Section: Introductionmentioning

confidence: 99%

Cumulative Probability of False-Positive Recall or Biopsy Recommendation After 10 Years of Screening Mammography

Hubbard

Kerlikowske

Flowers

et al. 2012

Obstetrical &Amp; Gynecological Survey

112

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Effect of Previous Benign Breast Biopsy on the Interpretive Performance of Subsequent Screening Mammography

Abstract: Self-reported benign breast biopsy history was associated with statistically significantly reduced mammography performance. The difference in performance was likely because of tissue characteristics rather than the biopsy itself.

Cited by 17 publications

References 29 publications

Patient and Radiologist Characteristics Associated With Accuracy of Two Types of Diagnostic Mammograms

Patient and Radiologist Characteristics Associated With Accuracy of Two Types of Diagnostic Mammograms

Cumulative Probability of False-Positive Recall or Biopsy Recommendation After 10 Years of Screening Mammography

Cumulative Probability of False-Positive Recall or Biopsy Recommendation After 10 Years of Screening Mammography

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