Mammography screening using independent double reading with consensus: is there a potential benefit for...

Area of Science:

• Radiology and Medical Imaging
• Oncology
• Public Health

Background:

• Double reading enhances cancer detection in mammography screening.
• Computer-aided detection (CAD) is a potential alternative to double reading.
• The benefit of CAD in conjunction with double reading requires further investigation.

Purpose of the Study:

• To compare independent double reading of screen-film (SFM) and full-field digital mammography (FFDM) during population-based screening.
• To assess the retrospective performance of standalone CAD on baseline mammograms.
• To evaluate CAD's impact on screen-detected and subsequent cancers.

Main Methods:

• Analysis of 23,923 screening mammograms (SFM and FFDM) using a 5-point cancer probability scale.
• Retrospective classification of 104 subsequent cancers' baseline mammograms as normal, non-specific minimal signs, significant minimal signs, or false-negatives.
• Evaluation of baseline mammograms for screen-detected and subsequent cancers using CAD, identifying 'actionable' findings.

Main Results:

• CAD correctly marked 94% of baseline mammograms for screen-detected cancers.
• CAD had the potential to increase the cancer detection rate from 0.43% to 0.51% for subsequent cancers.
• CAD could potentially increase overall cancer detection by 16% and decrease interval cancers by 20%.

Conclusions:

• Computer-aided detection (CAD) may enhance mammography screening programs that use double reading.
• CAD shows potential to increase cancer detection rates and reduce interval cancers.
• Prospective studies are needed to evaluate CAD's influence on clinical decision-making.