Mammography reading: ideas for personal audit

Author(s): Dr Jim Steel

Hospital: Derriford Hospital

Reference: RAD Magazine, 46, 540, 15-17

Excerpt: 

The emphasis of mammography reader training is, understandably, on breast cancer. What we don’t focus on so much is reducing recall rates. Cancer is detected in around eight per 1,000 of our screening mammograms, yet routinely we call back 50 per 1,000 or more. This is largely unavoidable – the task is very difficult. But what is more worrying is that the variation in recall rate across the country is remarkable. In some areas you are far more likely to be called back than in others: in the east of England you have only a 2% chance of an assessment appointment, but move near one unit in the north-west and you would more than triple that chance. The range is greater still when you look at just the prevalent (first time) screen.

Unit recall rates vary a lot. This must mean that culturally we are led by those around us in our reading behaviour; indeed sometimes readers moving from one culture to another will change their recall rate to match.2 But variation between readers within one unit is often even higher.

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