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Variability of Breast Density Classification Between US and UK Radiologists.

Wijdan Alomaim1, Desiree O'Leary2, John Ryan1

  • 1Radiography & Diagnostic Imaging, School of Medicine, University College Dublin, Ireland.

Journal of Medical Imaging and Radiation Sciences
|February 20, 2019
PubMed
Summary
This summary is machine-generated.

Radiologists in the US and UK show variations in subjective breast density assessment using BI-RADS categories. A two-scale method improved agreement, highlighting the need for standardized, automated breast density assessment for better screening.

Keywords:
BI-RADSBreast densityintrarater variabilitymammography

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Area of Science:

  • Radiology
  • Medical Imaging
  • Breast Health

Background:

  • Subjective breast density categorization is standard but may lack consistency.
  • Geographic variations in national legislation could influence interpretation.
  • Accurate breast density assessment is crucial for individualized screening.

Purpose of the Study:

  • To evaluate if subjective breast density categorization is optimal.
  • To identify geographic variations in mammographic breast density assessment.
  • To compare breast density categorization between UK and US radiologists.

Main Methods:

  • 250 anonymized mammograms were reviewed by UK and US radiologists.
  • Subjective breast density was rated using Breast Imaging Reporting and Data System (BI-RADS) categories.
  • Inter-rater reliability was assessed using the Kappa test.

Main Results:

  • US radiologists classified fewer images as 'mostly fatty' compared to UK radiologists.
  • Higher BI-RADS categories were assigned more frequently by US radiologists.
  • Substantial overall agreement (k=0.654) was observed, but agreement varied by BI-RADS category.

Conclusions:

  • Significant variations exist in subjective breast density classification between US and UK radiologists.
  • A two-scale categorization method (low, high) demonstrated improved inter-rater agreement.
  • Standardized and automated breast density assessment is recommended to enhance screening accuracy.