Accuracy of short-interval follow-up mammograms by patient and radiologist characteristics

Erin J. Aiello Bowles, Diana L. Miglioretti, Edward A. Sickles, Linn Abraham, Patricia A. Carney, Bonnie C. Yankaskas, Joann G. Elmore

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

OBJECTIVE. The purpose of our study was to examine the accuracy of short-interval follow-up mammograms and evaluate patient and radiologist characteristics associated with accuracy. MATERIALS AND METHODS. We evaluated 45,007 initial short-interval follow-up mammograms from the Breast Cancer Surveillance Consortium interpreted 3-9 months after a probably benign assessment on a screening or diagnostic examination between 1994 and 2004. We linked these mammograms with patient characteristics and breast cancer diagnoses within 12 months. A subset of short-interval follow-up examinations (n = 13,907) was merged with radiologist characteristics collected from survey data from 130 interpreting radiologists. Using logistic regression, we fit generalized estimating equations to model sensitivity and specificity of short-interval follow-up mammograms by patient and radiologist characteristics. RESULTS. For every 1,000 women, 8.0 women (0.8%) were diagnosed with breast cancer within 6 months and 11.3 (1.1%) within 12 months. Sensitivity was 83.3% (95% CI, 79.4-87.3%) for cancers diagnosed within 6 months and 60.5% (56.2-64.7%) for those diagnosed within 12 months. Specificity was 97.2% (96.9-97.6%) at 6 months and 97.3% (96.9-97.6%) at 12 months. Sensitivity at 12 months increased among women with unilateral short-interval follow-up mammograms (odds ratio, 1.56 [95% CI, 1.06-2.29]) and when the interpreting radiologist spent more than 10 hours a week in breast imaging (odds ratio, 3.25 [1.00-10.52]). CONCLUSION. Initial short-interval follow-up mammography examinations had a lower sensitivity for detecting breast cancer within 12 months than other diagnostic mammograms (61% for short-interval follow-up vs 80% for diagnostic mammograms reported in the literature). However, sensitivity within the 6-month interval that is usually recommended for subsequent follow-up was 83%. Accuracy of short-interval follow-up mammograms was influenced by few patient and radiologist characteristics.

Original languageEnglish (US)
Pages (from-to)1200-1208
Number of pages9
JournalAmerican Journal of Roentgenology
Volume190
Issue number5
DOIs
StatePublished - May 1 2008

Keywords

  • Breast cancer
  • Diagnostic mammography
  • Sensitivity
  • Short-interval follow-up mammography
  • Specificity

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Aiello Bowles, E. J., Miglioretti, D. L., Sickles, E. A., Abraham, L., Carney, P. A., Yankaskas, B. C., & Elmore, J. G. (2008). Accuracy of short-interval follow-up mammograms by patient and radiologist characteristics. American Journal of Roentgenology, 190(5), 1200-1208. https://doi.org/10.2214/AJR.07.3041