Comparison of Radiographer/Radiologist Double Film Reading with Single Reading in Breast Cancer Screening

Abstract

Objectives— To assess the efficacy of dual film reading in screening mammography with a suitably trained radiographer as the second reader and to determine a suitable decision model for radiographer/radiologist double reading. Setting— Three breast screening centres in South Thames (West) region. Methods— Seven radiographers with prior film reading training double read 17 202 screening mammograms with a radiologist. Screening performance of radiographers and radiologists was assessed taking into account interval cancers. The efficacy of radiographer/radiologist double reading was assessed in terms of changes in sensitivity and specificity compared with radiologist single reading. Results— Radiographers yielded equivalent sensitivity but lower specificity than radiologist film readers. The effect of double reading between radiographer/radiologist pairs was an increase in sensitivity of 6.4%, which was achieved at the cost of a 0.6% decrease in specificity. This was reached by a decision system involving radiologists' review of radiographer queries and recall classifications. If all radiographer queries were recalled a large increase in sensitivity would be counterbalanced by an equally large decrease in specificity. Conclusions— Radiographer/radiologist double reading resulted in similar increases in sensitivity as those previously reported in radiologist double reading studies. Radiologist review of radiographer reported abnormalities is a suitable means by which to limit excess recall.