Characteristics of screen-detected cancers following concordant or discordant recalls at blinded double reading in biennial digital screening mammography
- PMID: 29943181
- DOI: 10.1007/s00330-018-5586-9
Characteristics of screen-detected cancers following concordant or discordant recalls at blinded double reading in biennial digital screening mammography
Abstract
Objectives: To analyse which mammographic and tumour characteristics led to concordant versus discordant recalls at blinded double reading to further optimise our breast cancer screening programme.
Methods: We included a consecutive series of 99,013 screening mammograms obtained between July 2013 and January 2015. All mammograms were double read in a blinded fashion. Discordant readings were routinely recalled without consensus or arbitration. During the 2-year follow-up, relevant data of the recalled women were collected. We compared mammographic characteristics, screening outcome and tumour characteristics between concordant and discordant recalls.
Results: There were 2,543 concordant recalls (71.4%) and 997 discordant recalls (28.0%). The positive predictive value of a concordant recall was significantly higher (23.5% vs. 10.0%, p < 0.001). The proportion of BI-RADS 0 was significantly higher in the discordant recall group (75.7% vs. 56.3%, p < 0.001). Discordant recalls were more often an asymmetry or architectural distortion (21.8% vs. 13.2% and 9.3% vs. 6.5%, respectively, p < 0.001). There were no differences in the distribution of DCIS and invasive cancers and tumour characteristics were comparable for the two groups, except for a more favourable tumour grade in the discordant recall group (54.7% vs. 39.9% grade I tumours, p = 0.022).
Conclusions: Screen-detected cancers detected by a discordant reading show a more favourable tumour grade than cancers diagnosed after a concordant recall. The higher proportion of asymmetries and architectural distortions in this group provide a possible target for improving screening programmes by additional training of screening radiologists and the implementation of digital breast tomosynthesis.
Key points: • With blinded double reading of screening mammograms, screen-detected cancers detected by a discordant reading show a more favourable tumour grade than cancers diagnosed after a concordant recall. • The proportions of asymmetries and architectural distortions are higher in case of a discordant reading. • Possible improvement strategies could target additional training of screening radiologists and the implementation of digital breast tomosynthesis in breast cancer screening programmes.
Keywords: Breast neoplasms; Early detection of cancer; Follow-up studies; Mammography; Mass screening.
Similar articles
-
Arbitration of discrepant BI-RADS 0 recalls by a third reader at screening mammography lowers recall rate but not the cancer detection rate and sensitivity at blinded and non-blinded double reading.Breast. 2015 Oct;24(5):601-7. doi: 10.1016/j.breast.2015.06.004. Breast. 2015. PMID: 26117723
-
Incorporation of the technologist's opinion for arbitration of discrepant assessments among radiologists at screening mammography.Breast Cancer Res Treat. 2018 Aug;171(1):143-149. doi: 10.1007/s10549-018-4800-4. Epub 2018 May 5. Breast Cancer Res Treat. 2018. PMID: 29730729
-
One-view breast tomosynthesis versus two-view mammography in the Malmö Breast Tomosynthesis Screening Trial (MBTST): a prospective, population-based, diagnostic accuracy study.Lancet Oncol. 2018 Nov;19(11):1493-1503. doi: 10.1016/S1470-2045(18)30521-7. Epub 2018 Oct 12. Lancet Oncol. 2018. PMID: 30322817 Clinical Trial.
-
Digital breast tomosynthesis (3D-mammography) screening: A pictorial review of screen-detected cancers and false recalls attributed to tomosynthesis in prospective screening trials.Breast. 2016 Apr;26:119-34. doi: 10.1016/j.breast.2016.01.007. Epub 2016 Feb 18. Breast. 2016. PMID: 27017251 Review.
-
Double reading in breast cancer screening: considerations for policy-making.Br J Radiol. 2020 Feb 1;93(1106):20190610. doi: 10.1259/bjr.20190610. Epub 2019 Oct 23. Br J Radiol. 2020. PMID: 31617741 Free PMC article. Review.
Cited by
-
Consensus Reads: The More Sets of Eyes Interpreting a Mammogram, the Better for Women.Radiology. 2020 Apr;295(1):42-43. doi: 10.1148/radiol.2020192746. Epub 2020 Feb 11. Radiology. 2020. PMID: 32053060 Free PMC article. No abstract available.
-
Interhospital variations in diagnostic work-up following recall at biennial screening mammography-a population-based study.Eur Radiol. 2025 Jul;35(7):3964-3978. doi: 10.1007/s00330-024-11302-5. Epub 2024 Dec 21. Eur Radiol. 2025. PMID: 39708083
References
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical