Differential Value of Comparison with Previous Examinations in Diagnostic Versus Screening Mammography
- 1 November 2002
- journal article
- Published by American Roentgen Ray Society in American Journal of Roentgenology
- Vol. 179 (5), 1173-1177
- https://doi.org/10.2214/ajr.179.5.1791173
Abstract
OBJECTIVE. The purpose of our study was to analyze the differences in clinical outcomes of diagnostic and screening mammography depending on whether comparison is made with previous examinations. MATERIALS AND METHODS. We analyzed 48,281 consecutive mammography examinations for which previous mammography (9825 diagnostic, 38,456 screening) had been performed between 1997 and 2001, collecting data on demographics, whether comparison actually was made with previous examinations, abnormal findings (recall for screening mammography or biopsy recommendation for diagnostic mammography), biopsy yield of cancer, cancer detection rate, size of invasive cancers, axillary nodal status, and cancer stage. RESULTS. Comparison with previous examinations in the incidence screening setting decreases the recall rate from 4.9% to 3.8% (p < 0.0001) but does not significantly affect the biopsy yield (40-44%, p = 0.56) or the cancer detection rate (5.5-5.2/1000, p = 0.87). In the diagnostic setting, comparison with previous examinations increases the biopsy-recommended rate from 4.3% to 9.4% (p < 0.0001), the biopsy yield from 38% to 51% (p = 0.12), and the overall cancer detection rate from 11/1000 to 39/1000 (p < 0.0001). Comparison with previous examinations is not associated with a significant difference in mean tumor size. However, it is associated with a significant decrease in the frequency of axillary node metastasis and the cancer stage for screening mammography, but not for diagnostic mammography. CONCLUSION. For screening mammography, comparison with previous examinations significantly decreases false-positive but not true-positive findings and permits detection of cancers at an earlier stage. For diagnostic mammography, comparison with previous examinations increases true-positive findings.Keywords
This publication has 10 references indexed in Scilit:
- Medical Audit of Diagnostic Mammography ExaminationsAmerican Journal of Roentgenology, 2001
- Effect on Sensitivity and Specificity of Mammography Screening with or Without Comparison of Old MammogramsActa Radiologica, 2000
- A comparison of cancer detection rates achieved by breast cancer screening programmes by number of readers, for one and two view mammography: results from the UK National Health Service breast screening programmeJournal of Medical Screening, 1998
- Results from the Ontario breast screening program, 1990–1995Journal of Medical Screening, 1998
- The influence of previous films on screening mammographic interpretation and detection of breast carcinomaClinical Radiology, 1997
- The South Australian Breast X-Ray Service: results from a statewide mammographic screening programmeBritish Journal of Cancer, 1996
- Initial versus subsequent screening mammography: comparison of findings and their prognostic significance.American Journal of Roentgenology, 1995
- A private breast imaging practice: medical audit of 25,788 screening and 1,077 diagnostic examinations.Radiology, 1993
- The usefulness of computers in managing the operation of a mammography screening practice.American Journal of Roentgenology, 1990
- Mammography screening — reasons for recall and the influence of experience on recall in the finnish systemClinical Radiology, 1990