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Is the false-positive rate in mammography in North America too high?
- Source :
-
The British journal of radiology [Br J Radiol] 2016 Sep; Vol. 89 (1065), pp. 20160045. Date of Electronic Publication: 2016 Jun 08. - Publication Year :
- 2016
-
Abstract
- The practice of investigating pathological abnormalities in the breasts of females who are asymptomatic is primarily employed using X-ray mammography. The importance of breast screening is reflected in the mortality-based benefits observed among females who are found to possess invasive breast carcinoma prior to the manifestation of clinical symptoms. It is estimated that population-based screening constitutes a 17% reduction in the breast cancer mortality rate among females affected by invasive breast carcinoma. In spite of the significant utility that screening confers in those affected by invasive cancer, limitations associated with screening manifest as potential harms affecting individuals who are free of invasive disease. Disease-free and benign tumour-bearing individuals who are subjected to diagnostic work-up following a screening examination constitute a population of cases referred to as false positives (FPs). This article discusses factors contributing to the FP rate in mammography and extends the discussion to an assessment of the consequences associated with FP reporting. We conclude that the mammography FP rate in North America is in excess based upon the observation of overtreatment of in situ lesions and the disproportionate distribution of detriment and benefit among the population of individuals recalled for diagnostic work-up subsequent to screening. To address the excessive incidence of FPs in mammography, we investigate solutions that may be employed to remediate the current status of the FP rate. Subsequently, it can be suggested that improvements in the breast-screening protocol, medical litigation risk, image interpretation software and the implementation of image acquisition modalities that overcome superimposition effects are promising solutions.
- Subjects :
- Breast Neoplasms epidemiology
Breast Neoplasms surgery
Canada epidemiology
Early Detection of Cancer
False Positive Reactions
Female
Health Policy
Humans
Incidence
Practice Patterns, Physicians'
Prevalence
Radiologists standards
Risk Assessment
United States epidemiology
Breast Neoplasms diagnostic imaging
Mammography standards
Subjects
Details
- Language :
- English
- ISSN :
- 1748-880X
- Volume :
- 89
- Issue :
- 1065
- Database :
- MEDLINE
- Journal :
- The British journal of radiology
- Publication Type :
- Academic Journal
- Accession number :
- 27187600
- Full Text :
- https://doi.org/10.1259/bjr.20160045