Abstract
Background
During locally organized quality assurance evaluation sessions for screening radiologists, we noticed that individual screening radiologists did miss tumours which in our opinion could be detected at a distance.
Aim
To determine whether tumours missed by individual screening radiologists can be detected at a distance.
Methods
Twenty-eight screening mammograms of 28 females (mean age 63 years, range 49–73) with a pathologically proven malignant tumour missed by individual screening radiologists were mixed with 56 normal screening mammograms of 56 females (mean age 63 years, range 53–74). This test set was independently assessed by a senior screening radiologist and by a radiology resident without prior training in screening mammography at 1.5 m distance from the screen display. Readers were unaware of the prevalence of pathologically proven malignant tumours in the test set. Primary outcome was whether the reader would recall the woman.
Results
The senior screening radiologist recalled 28 of 28 women with a pathologically proven malignant tumour (sensitivity of 100%) and 16 of 56 women without pathology (specificity of 71%). The radiology resident recalled 25 of 28 women with a pathologically proven malignant tumour (sensitivity of 89%) and 10 of 56 women without pathology (specificity of 82%).
Conclusion
Some malignant tumours missed by an individual screening radiologist can be detected from 1.5 m distance. Therefore, we recommend that screening radiologists consciously take a distant view before closely evaluating the mammogram in detail.
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Acknowledgements
The authors thank M.S.O. van Wissen, MD for reading the test set during her residency in radiology.
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Authors declare that they have no conflict of interest.
Ethical approval
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.
Informed consent
In accordance with the national Data Protection Act, women were informed at screening that their data could be used anonymously for scientific research. Women can opt out, if they do not agree. The test set only consisted of screening mammograms of women who agreed to opt in.
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Schreutelkamp, I.L., Kwee, R.M., Veekmans, P. et al. Breast cancers missed by screening radiologists can be detected by reading mammograms at a distance. Ir J Med Sci 188, 289–293 (2019). https://doi.org/10.1007/s11845-018-1828-8
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DOI: https://doi.org/10.1007/s11845-018-1828-8