Taylor-Phillips, Sian, Jenkinson, David J., Stinton, Chris, Wallis, Matthew G., Dunn, Janet A. and Clarke, Aileen (2018) Double reading in breast cancer screening : cohort evaluation in the CO-OPS trial. Radiology, 287 (3). pp. 749-757. 171010. doi:10.1148/radiol.2018171010 ISSN 0033-8419.

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Abstract

Purpose:

To investigate the effect of double readings by a second radiologist on recall rates, cancer detection and characteristics of cancers detected in the National Health Service Breast Screening Program in England.

Materials and Methods:

In this retrospective analysis we evaluated 805,206 women through screening and diagnostic test results by extracting one year of routine data from 33 English breast screening centers. Centers used double reading of digital mammograms, with arbitration if there were discrepant reads. Information on reader decisions, with results of follow-up tests, were used to explore the effect of the second reader. The statistical tests used were the test for equality of proportions, the χ2 test for independence and the t-test.

Results:

The first reader recalled 4·76%, (38295/805206, 95% CI 4·71%-4·80%) of women. Two readers recalled 6·19% in total, (49857/805206, 95% CI 6·14%- 6·24%), but arbitration of discordant reads reduced recall rate to 4·08%, (32863/805206, 95% CI 4·04%-4·12%, p<0.001). 7055 cancers were detected of which 627 (8·89%, 95% CI 8·22%-9·55%, p<0.001) were detected by the second reader only. These additional cancers were more likely to be ductal carcinoma in situ, (30·5% (183/600) vs 22.0% (1344/6114), p<0.001); and additional invasive cancers were smaller (mean 14·2mm vs 16·7mm, p<0.001), had fewer involved nodes, and were likely to be lower grade.

Conclusion:

Double reading with arbitration reduces recall and increases cancer detection compared to single reading. Cancers detected only by the second reader were smaller, lower grade, and had less nodal involvement.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Breast -- Cancer -- Diagnosis, Medical screening, Radiology
Journal or Publication Title:	Radiology
Publisher:	Radiological Society of North America, Inc.
ISSN:	0033-8419
Official Date:	June 2018
Dates:	Date Event June 2018 Published 10 April 2018 Available 8 January 2018 Accepted
Volume:	287
Number:	3
Page Range:	pp. 749-757
Article Number:	171010
DOI:	10.1148/radiol.2018171010
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	24 April 2018
Date of first compliant Open Access:	10 October 2018
RIOXX Funder/Project Grant:	Project/Grant ID RIOXX Funder Name Funder ID CDF-2016-09-018 National Institute for Health Research http://dx.doi.org/10.13039/501100000272

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