Impact of the second reader on screening outcome at blinded double reading of digital screening mammograms
Menée à partir de 99 013 clichés de mammographies numériques réalisées entre juillet 2013 et janvier 2015 et à partir de données clinico-pathologiques, cette étude évalue, du point de vue du taux de rappel, du taux de détection et du taux de faux positif, l'intérêt d'une double lecture
Background : To determine the impact of the second reader on screening outcome at blinded double reading of digital screening mammograms.
Methods : We included a consecutive series of 99,013 digital screening mammograms, obtained between July 2013 and January 2015 and double read in a blinded fashion. During 2-year follow-up, we collected radiology, surgery and pathology reports of recalled women.
Results : Single reading resulted in 2928 recalls and 616 screen-detected cancers (SDCs). The second reader recalled another 612 women, resulting in 82 additional SDCs. Addition of the second reader increased the recall rate (3.0% to 3.6%, p < 0.001), cancer detection rate (6.2–7.0 per 1000 screens, p < 0.001) and false positive recall rate (24.4–28.7 per 1000 screens, p < 0.001). Positive predictive value of recall (21.0% vs. 19.7%, p = 0.20) and of biopsy (52.1% vs. 50.9%, p = 0.56) were comparable for single reading and blinded double reading. Tumour characteristics were comparable for cancers detected by the first reader and cancers additionally detected by the second reader, except of a more favourable tumour grade in the latter group.
Conclusions : At blinded double reading, the second reader significantly increases the cancer detection rate, at the expense of an increased recall rate and false positive recall rate.
British Journal of Cancer , résumé, 2018