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Published on: December 15, 2014
[Breast density assessment and organised breast cancer screening]
Augustin Tozoula Bambara1, Nina-Astrid Ouédraogo2, Pakisba Ali Ouédraogo3
1Université Joseph Ki-Zerbo, Laboratoire des maladies non transmissibles, unité de formation et de recherche en sciences de la santé, Ouagadougou, Burkina Faso; Centre hospitalier universitaire Yalgado-Ouédraogo, service de cancérologie, Ouagadougou, Burkina Faso.
Introduction:
The objective of this study was to evaluate the intra- and inter-rater agreement of radiologists regarding the evaluation of breast density.
Methodology:
Breast density assessments of 120 cases were performed by four radiologists in the city of Ouagadougou according to the fifth edition of the American College of Radiology BI-RADS atlas. Cohen's weighted kappa coefficients and Fleiss kappa coefficients were used to estimate agreement between observers and with a panel of three experts radiologists. A new evaluation of the 120 cases was performed by all raters one month after the initial evaluation.
Results:
Inter-rater kappa coefficients ranged from 0.55 to 0.74. The Fleiss kappa coefficient was 0.58, 0.43, 0.41, and 0.43 for categories A, B, C, and D respectively. In terms of classification into "sparse breasts" and "dense breasts", the kappa coefficients ranged from 0.47 to 0.67. Taking the results of the expert panel as a reference, the proportion of false positives in the diagnosis "dense breasts" ranged from 18.6% to 26.8%. Intraobserver agreement was good.
Conclusion:
Our study showed moderate to good intra- and inter-raters agreements. Upgrading and harmonisation of practices will be used to empower radiologists to participate in organised breast cancer screening in Burkina Faso.
