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Women's Health

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Centers that offer screening mammograms only and have a breast specialist on site provide more accurate readings

Many studies have explored how the characteristics of women and radiologists affect the accuracy of mammogram interpretation. In a recent study, researchers examined how variations in the actual facility providing the mammogram affect the results. They reviewed 5 years of mammogram data and results of surveys received from 43 facilities and their 128 radiologists from the Pacific Northwest, New Hampshire, and Colorado. The researchers controlled for patient characteristics, such as breast density, age, and time between mammograms, and radiologist characteristics, such as years of experience in reading mammograms and the volume of mammograms read.

The most accurate facilities offered screening but not diagnostic mammograms, had a breast imaging specialist on staff, and conducted audits of radiologists' performance two or more times a year. Facility mammography volume did not appear to affect accuracy after the volume of radiologists was taken into consideration. Researchers were also surprised that having two or more radiologists read mammograms (double reading) did not increase accuracy rates, because this finding contradicts earlier studies. They suggest that either double reading may not be effectively employed at the facilities studied or the team's definition of double-reading did not include methods that do work.

These findings can assist physicians and women in choosing facilities that offer the best quality in screening mammograms because, while they can usually control what mammography facility is visited, they cannot control who will read the mammogram. This study was funded in part by the Agency for Healthcare Research and Quality (HS10591).

See "Mammography facility characteristics associated with interpretive accuracy of screening mammography," by Stephen Taplin, M.D., M.P.H., Linn Abraham, M.S., William E. Barlow, Ph.D., and others in the June 18, 2008, Journal of the National Cancer Institute 100(12), pp. 876-887.

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