Clinical Edge

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Mammographic Breast Density Assessments

Ann Intern Med; ePub 2016 Jul 19; Sprague, et al

There is a wide variation in mammographic breast density assessment and the likelihood of a woman being told she has dense breasts varies substantially according to which radiologist interprets her mammogram, according to a recent study, and providers and policymakers should consider this variation when considering supplemental screening strategies. This according to a multicenter study of radiologists who interpreted at least 500 screening mammograms during 2011 to 2013. Data on 216,783 screening mammograms from 145,123 women aged 40 to 89 years were included. Researchers found:

• 36.9% of mammograms were rated as showing dense breasts.

• Across radiologists, the percentage ranged from 6.3% to 84.5%.

• Variation in density assessment across radiologists was pervasive in all but the most extreme patient age and BMI combinations in patient subgroups.

• Among women with consecutive mammograms interpreted by different radiologists, 17.2% had discordant assessments of dense vs nondense status.

Citation: Sprague BL, Conant EF, Onega T, et al. Variation in mammographic breast density assessment among radiologists in clinical practice. A multicenter observational study. [Published online ahead of print July 19, 2016]. Ann Intern Med. doi:10.7326/M15-2934.