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Updated: Jul 28, 2025
Detection of Architectural Distortion in Prior Mammograms via Analysis of Oriented Patterns
Published on: August 30, 2013
Screening outcome for interpretation by the first and second reader in a population-based mammographic screening
Tone Hovda1, Silje Sagstad2, Marthe Larsen2
1Department of Radiology, Vestre Viken Hospital Trust, Drammen, Norway.
Background:
Double reading of screening mammograms is associated with a higher rate of screen-detected cancer than single reading, but different strategies exist regarding reader pairing and blinding. Knowledge about these aspects is important when considering strategies for future use of artificial intelligence in mammographic screening.
Purpose:
To investigate screening outcome, histopathological tumor characteristics, and mammographic features stratified by the first and the second reader in a population based screening program for breast cancer.
Material And Methods:
The study sample consisted of data from 3,499,048 screening examinations from 834,691 women performed during 1996-2018 in BreastScreen Norway. All examinations were interpreted independently by two radiologists, 272 in total. We analyzed interpretation score, recall, and cancer detection, as well as histopathological tumor characteristics and mammographic features of the cancers, stratified by the first and second readers.
Results:
For Reader 1, the rate of positive interpretations was 4.8%, recall 2.3%, and cancer detection 0.5%. The corresponding percentages for Reader 2 were 4.9%, 2.5%, and 0.5% (P < 0.05 compared with Reader 1). No statistical difference was observed for histopathological tumor characteristics or mammographic features when stratified by Readers 1 and 2. Recall and cancer detection were statistically higher and histopathological tumor characteristics less favorable for cases detected after concordant positive compared with discordant interpretations.
Conclusion:
Despite reaching statistical significance, mainly due to the large study sample, we consider the differences in interpretation scores, recall, and cancer detection between the first and second readers to be clinically negligible. For practical and clinical purposes, double reading in BreastScreen Norway is independent.
