The influence of breast density and key demographics of radiographers on mammography reporting performance – a pilot study

Abstract

Introduction: A high demand has been placed on radiologists to perform screen reads due to higher number of women undergoing mammography. This study aims to examine radiographer performance in reporting low compared with high-mammographic density (MD) images; and to assess the influence of key demographics of Jordanian radiographers on their performance. Methods: Thirty mammograms with varied MD were reported by 12 radiographers using the Breast Imaging-Reporting and Data System (BI-RADS). Radiographer performance was measured using sensitivity, specificity, positive (PPV) and negative predictive values (NPV), and area under the receiver operating characteristic curve (ROC AUC). Performance measures were compared between cases with low- and high-MD and between subgroups of radiographers according to key demographics. Results: All performance measures were significantly higher in low- compared to high-MD cases (P value < 0.0). The mean sensitivity, specificity, PPV, NPV and ROC AUC were 0.58, 0.68, 0.67, 0.63 and 0.69 respectively. PPV was significantly different for readers who had different years of experience in mammography, hours and cases per week P value = 0.023, 0.01, 0.017 respectively. ROC AUC was significantly different for radiographers with different number of hours and cases performed per week (P value = 0.001 and 0.004 respectively). Conclusions: The results of this pilot study are encouraging however a more extensive study is required to determine if Jordanian radiographers are capable of successfully taking part in breast screen reading. The lack of skills and knowledge required for correct and consistent reporting of high-MD images highlights the need for any formal training in mammographic interpretation to focus on the dense breast.