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Association between radiologists’ and facilities’ characteristics and mammography screening detection of ductal carcinoma in situ

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

The aim of our study was, first, to measure association between radiologists and facilities characteristics and DCIS detection. Second, to assess whether those characteristics affect differently the likelihood of detection of DCIS versus invasive breast cancer. When applicable, we examined whether the identified characteristics were similarly associated with low-grade and high-grade DCIS detection.

Methods

This retrospective cohort study included 1,750,002 digital screening mammograms (2145 screen-detected DCIS) performed in the Quebec breast cancer screening program between 2007 and 2015 inclusively. The associations between radiologists’ and facilities’ characteristics and (1) the DCIS detection rate, (2) the invasive detection rate, and (3) the odds of DCIS on invasive detection were assess. For statistically significant associations in the latter analysis, analyses stratified by DCIS grade were performed. Multivariable logistic regression with generalized estimating equations estimates to account for correlation among mammograms was used.

Results

Compared to radiologists with recall rate between 5.0 and 9.9%, radiologists with recall rate between 15.0–19.9% and ≥ 20% reached a higher DCIS detection rate, with adjusted detection ratios of, respectively, 1.33 (95% confidence interval = 1.15–1.53) and 1.43 (95% confidence interval = 1.13–1.81). Increase in radiologist’ recall rate was statistically significantly associated with an increase in detection of low/intermediate-grade DCIS (P < 0.001), while not in high-grade DCIS (P = 0.15).

Conclusions

A major determinant of DCIS detection is the radiologists’ recall rate. Abnormalities referred by radiologists with higher recall rates should be identified in order to understand how to decrease recall rate while keeping an optimal DCIS and invasive detection rate.

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Abbreviations

CDR:

Cancer detection rate

DCIS:

Ductal carcinoma in situ

ICD:

International classification of diseases

OR:

Odds ratio

PQDCS:

Programme Québécois de dépistage du cancer du sein (Quebec breast cancer screening program)

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Funding

This study was financially supported by the Direction générale de cancérologie of the Quebec Ministry of Health and Social Services.

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Authors and Affiliations

  1. Institut national de santé publique du Québec, 945, Av. Wolfe, Quebec City, G1V 5B3, Canada

    Isabelle Théberge, Nathalie Vandal, Linda Perron & Marie-Hélène Guertin

  2. Département de médecine sociale et préventive, Faculté de Médecine, Université Laval, Quebec City, Canada

    Isabelle Théberge & Linda Perron

  3. Département de santé publique et médecine préventive, CHU de Québec-Université Laval, Hôpital Saint-François d’Assise, Quebec City, Canada

    Linda Perron

Authors
  1. Isabelle Théberge
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  2. Nathalie Vandal
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  3. Linda Perron
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  4. Marie-Hélène Guertin
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Corresponding author

Correspondence to Isabelle Théberge.

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All authors declare that they have no conflict of interest.

Informed consent

All women included in this analysis signed a consent form agreeing to participate in the PQDCS, which includes transmission of their data to central database for analysis.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Théberge, I., Vandal, N., Perron, L. et al. Association between radiologists’ and facilities’ characteristics and mammography screening detection of ductal carcinoma in situ. Breast Cancer Res Treat 187, 255–266 (2021). https://doi.org/10.1007/s10549-020-06057-8

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  • DOI: https://doi.org/10.1007/s10549-020-06057-8

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