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Fewer false alarms when mammographers have greater experience screening healthy breasts

out mistaking normal tissue for a malignancy with greater accuracy than physicians whose volume was not as high. In general, the false-positive rate declined with increasing physician age, with increasing time since receipt of medical degree, and with increasing annual volume. Additionally, those physicians who focused their practice on screening, as opposed to diagnostic mammography, had a lower false-positive rate.

Study data came from four sites that participate in the National Cancer Institute- funded Breast Cancer Surveillance Consortium. Those sites -- San Francisco, New Mexico, Vermont and Colorado -- prospectively collect mammographic interpretations. Researchers linked the interpretation data to cancer registries and then to physician information from the American Medical Association. They studied 209 physicians who interpreted 1.2 million mammograms from January 1, 1995 through December 31, 2000 including 7143 that were associated with breast cancer.

The minimum number of mammograms a US physician can read and still be considered qualified under FDA regulations is 960 within a two-year period, or approximately 10 mammograms per week, according to the Mammography Quality Standards Act of 1992.

"Raising the annual volume requirements in the Act might improve the overall quality of screening mammography in the US," said principal investigator Rebecca Smith Bindman, MD, UCSF associate professor of radiology, epidemiology/biostatistics, and obstetrics, gynecology and reproductive sciences. She also is director of the UCSF Radiology Outcomes Research Lab and part of the breast oncology program of the UCSF Comprehensive Cancer Center.

The authors hypothesize that physicians who read more mammograms overall and who have been reading them longer develop a higher threshold for identifying cancer and overall do better. Those who read a higher proportion of diagnostic mammograms, they say, may tend to develop a lower threshold, expect
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Contact: Eve Harris
eharris@pubaff.ucsf.edu
415-885-7277
University of California - San Francisco
1-Mar-2005


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