Abstract
Higher recall rates have been related to increased false positive decisions, causing significant psychological and economical costs for both screened women and the mammography screening service respectively. This study compares breast readers’ performance in a laboratory setting under varying levels of recall rates. Four experienced radiologists volunteered to read a single test set of 200 mammographic cases over three separate conditions. The test set contained of 180 normal and 20 abnormal cases and the participants were asked to identify each case that required to be recalled in line with three different target recall rates: control (unspecified or free recall (first read)), 15 % (second read) and 10 % (third read). Readers were required to mark the location of any malignancies using custom made detection software. The recall rates for the control condition ranged between 18.5 % and 34 %. Statistically significant differences were observed in sensitivity for control (median = 0.85) vs 15 % (median = 0.65, z = -2.381, P = 0.017), 15 % vs 10 % (median = 0.55, z = -2.428, P = 0.015) and control vs 10 % (z = -2.381, P = 0.017). ROC AUC was significantly different for control (median = 0.84) vs 15 % (median = 0.79, z = -2.381, P = 0.017) and 15 % vs 10 % (median = 0.75, z = -2.381, P = 0.017). Specificity significantly improved at lower recall rate of 10 % (median = 0.95) vs 15 % (median = 0.92, z = -2.428, P = 0.017). Setting specific target recall rates for readers significantly limited their performance in correctly identifying cancers. In this study, decreasing the number of recalled cases down to 10 %, significantly reduced cancer detection, with a significant improvement in specificity (P ≤ 0.05).
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Hofvind, S., et al.: False-positive results in mammographic screening for breast cancer in Europe: a literature review and survey of service screening programmes. J. Med. Screen. 19(suppl 1), 57–66 (2012)
Brewer, N.T., Salz, T., Lillie, S.E.: Systematic review: the long-term effects of false-positive mammograms. Ann. Intern. Med. 146(7), 502–510 (2007)
Yankaskas, B.C., et al.: International comparison of performance measures for screening mammography: can it be done? J. Med. Screen. 11(4), 187–193 (2004)
Berns, E.A., Hendrick, R.E., Cutter, G.R.: Performance comparison of full-field digital mammography to screen-film mammography in clinical practice. Med. Phys. 29(5), 830–834 (2002)
Lewin, J., et al.: Comparison of full-field digital mammography with screen-film mammography for cancer detection: results of 4,945 paired examinations. Radiology 218(3), 873–880 (2001)
Castells, X., Molins, E., Macia, F.: Cumulative false positive recall rate and association with participant related factors in a population based breast cancer screening programme. J. Epidemiol. Community Health 60(4), 316–321 (2006)
Carney, P.A., et al.: Individual and combined effects of age, breast density, and hormone replacement therapy use on the accuracy of screening mammography. Ann. Intern. Med. 138(3), 168–175 (2003)
Lehman, C.D., et al.: Effect of age and breast density on screening mammograms with false-positive findings. Am. J. Roentgenol. 173(6), 1651–1655 (1999)
Boyd, N.F., et al.: Mammographic density and the risk and detection of breast cancer. New Engl. J. Med. 356(3), 227–236 (2007)
Gur, D., et al.: Recall and detection rates in screening mammography. Cancer 100(8), 1590–1594 (2004)
BreastScreen Australia. National Accreditation Standards: BreastScreen Australia Quality (2008). http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/A03653118215815BCA257B41000409E9/$File/standards.pdf. Accessed 21 May 2014
Yankaskas, B.C., et al.: Association of recall rates with sensitivity and positive predictive values of screening mammography. Am. J. Roentgenol. 177(3), 543–549 (2001)
Otten, J.D.M., et al.: Effect of recall rate on earlier screen detection of breast cancers based on the dutch performance indicators. J. Nat. Cancer Inst. 97(10), 748–754 (2005)
Schell, M.J., et al.: Evidence-based target recall rates for screening mammography. Radiology 243(3), 681–689 (2007)
Elmore, J.G., et al.: International variation in screening mammography interpretations in community-based programs. J. Nat. Cancer Inst. 95(18), 1384–1393 (2003)
Soh, B.P., et al.: Mammography test sets: reading location and prior images do not affect group performance. Clin. Radiol. 69(4), 397–402 (2014)
Soh, B.P., et al.: Screening mammography: test set data can reasonably describe actual clinical reporting. Radiology 268(1), 46–53 (2013)
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this paper
Cite this paper
Norsuddin, N.M., Mello-Thoms, C., Reed, W., Brennan, P.C., Lewis, S. (2016). Lower Recall Rates Reduced Readers’ Sensitivity in Screening Mammography. In: Tingberg, A., Lång, K., Timberg, P. (eds) Breast Imaging. IWDM 2016. Lecture Notes in Computer Science(), vol 9699. Springer, Cham. https://doi.org/10.1007/978-3-319-41546-8_15
Download citation
DOI: https://doi.org/10.1007/978-3-319-41546-8_15
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-41545-1
Online ISBN: 978-3-319-41546-8
eBook Packages: Computer ScienceComputer Science (R0)