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This article was published at www.annals.org on 19 July 2016.
The full report is titled “Variation in Mammographic Breast Density Assessments Among Radiologists in Clinical Practice. A Multicenter Observational Study.” The authors are B.L. Sprague, E.F. Conant, T. Onega, M.P. Garcia, E.F. Beaber, S.D. Herschorn, C.D. Lehman, A.N.A. Tosteson, R. Lacson, M.D. Schnall, D. Kontos, J.S. Haas, D.L. Weaver, and W.E. Barlow, on behalf of the PROSPR Consortium.
Variation in Assessments of Breast Density on Mammograms in Clinical Practice. Ann Intern Med. 2016;165:I-28. doi: 10.7326/P16-9021
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Published: Ann Intern Med. 2016;165(7):I-28.
Published at www.annals.org on 19 July 2016
Women with dense breasts are at higher risk for breast cancer. About half of the United States require that information on the density of a woman's breasts be made available to her after a mammogram, and in some states the report must also inform such women about additional tests, such as breast magnetic resonance imaging (MRI), that may detect breast cancer in women who have dense breasts and normal mammograms.
To see whether radiologists vary in interpreting mammograms as showing increased breast density.
83 radiologists who interpreted at least 500 mammograms over 3 years in 30 different facilities that were part of 3 breast cancer research groups.
Radiologist reports were reviewed for 216,783 mammograms performed on 145,123 women between the ages of 40 and 89 years who had never had a diagnosis of breast cancer and who were having a mammogram for screening (not because they had symptoms of breast cancer, such as a breast lump).
Overall, slightly more than one third of mammograms were rated as showing increased breast density. However, the percentage of mammograms that a particular radiologist interpreted as showing increased breast density ranged widely, from about 6% to almost 85%. This variation among radiologists did not seem to be due to differences in the characteristics of the women who were examined, such as age, race, or body mass index. When women had 2 consecutive mammograms read by the same radiologist, about 17% had a finding of increased breast density reported on one mammogram but not the other.
The use of additional methods of determining breast density on mammograms, such as automated computer interpretation, was not determined, and the type of mammography equipment used was not analyzed.
The likelihood that a woman will be told that she has dense breasts on a mammogram may vary depending on which radiologist interprets her examination. Health care providers and policymakers should consider this when they make recommendations for individual patients and develop overall policies for patient notification and supplemental testing.
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Hematology/Oncology, Breast Cancer.
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