Double reading mammograms in the symptomatic setting.

Area of Science:

• Radiology
• Oncology
• Breast Imaging

Background:

• Symptomatic breast clinics offer specialized assessment and treatment.
• The UK's National Health Service Breast Screening Programme (NHSBSP) uses double reading for asymptomatic women.
• The efficacy of double reading in symptomatic settings is under investigation.

Purpose of the Study:

• To evaluate the impact of single versus double reader mammograms on cancer detection rates.
• To assess the effect of arbitration on time delays in symptomatic and surveillance breast clinics.

Main Methods:

• Retrospective analysis of symptomatic and surveillance clinic cases (2021-2023).
• Focused on discordant cases requiring arbitration (BI-RADS M3-M5 vs. M1-M2).
• 164 out of 9405 patients (1.74%) met inclusion criteria for arbitration analysis.

Main Results:

• Arbitration introduced an average delay of 12.7 days.
• In surveillance cases, arbitration downgraded 38 of 44 recalled cases, but a second reader recalled 13, leading to 4 malignancies.
• In symptomatic cases, arbitration led to 4 additional malignancies, 5 unknown malignant potential, and 9 benign results.

Conclusions:

• Double reading with arbitration enhances cancer detection rates, particularly in surveillance cohorts.
• Despite a 12.7-day delay, the arbitration process identified significant findings, including malignancies and B3 lesions.
• The study underscores the value of double reading and arbitration in improving diagnostic accuracy for breast conditions.