Radiologist agreement for mammographic recall by case difficulty and finding type

Area of Science:

• Radiology
• Medical Imaging
• Breast Cancer Screening

Background:

• Mammography is a key tool for breast cancer screening.
• Variability in radiologist interpretation can affect screening accuracy.
• Improving diagnostic performance is crucial for patient outcomes.

Purpose of the Study:

• To evaluate agreement between community radiologists and expert panels in mammographic interpretation.
• To identify specific mammographic findings with low interpretation agreement.
• To inform strategies for enhancing mammographic performance.

Main Methods:

• 119 radiologists interpreted 109 screening mammograms.
• Comparison with expert panel consensus on findings (mass, calcifications, asymmetric density, architectural distortion).
• Analysis of recall agreement, finding type concordance, and unnecessary recalls.

Main Results:

• 100% agreement for obvious findings and masses.
• Lower agreement for subtle or asymmetric lesions (50-60% in cancer cases).
• Low agreement for architectural distortions (43%) and asymmetric densities (40%), contributing to unnecessary recalls.

Conclusions:

• Significant disparities exist in mammographic interpretation, particularly for asymmetric densities and architectural distortions.
• Focused training on these challenging findings is recommended.
• Improving interpretation accuracy can lead to reduced unnecessary recalls and better screening efficiency.