Screening mammography: clinical image quality and the risk of interval breast cancer

AJR. American Journal of Roentgenology
Stephen H TaplinEmily White

Abstract

We evaluated the association between clinical image quality and breast cancer occurrence within 24 months of a negative mammogram. We identified women with breast cancer who were younger than 40 years old and older and screened from January 1, 1988, through December 31, 1993. We retrospectively assigned Breast Imaging Reporting and Data System (BI-RADS) assessments to their screening mammogram. We classified cancers (invasive or ductal in situ) as "screen-detected" when found after positive assessments (BI-RADS codes 3, 4, and 5) and "interval-detected" when found after negative assessments (BI-RADS codes 1 and 2). One reviewer evaluated mediolateral oblique and craniocaudal views for all cancer cases using a 3-point scale (failure, borderline, pass) for each measure of clinical image quality (positioning, breast compression, contrast, exposure, noise, sharpness, artifacts, overall quality). We used separate logistic regression models and evaluated the odds of interval invasive cancer or invasive plus in situ cancer as a function of each measure of quality using "pass" as the referent group. We found 492 screen-detected and 164 interval-detected cancers that met study criteria. Cancer detection (sensitivity) was highest (84%) a...Continue Reading

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