Radiologist Experience May Affect Screening Mammography Recall Rate

Radiologist annual reading volume and experience affects mammography screening recall rates, according to a study published in the Journal of the American College of Radiology.

Researchers from Brigham and Women’s Hospital in Boston, Mass., undertook a retrospective study to evaluate patient, radiologist, and examination characteristics affecting screening mammography recall rates and to identify modifiable factors that could reduce recall variation.

The researchers reviewed screening mammographic examinations in female patients interpreted by 13 breast imaging specialists at an academic center and two outpatient centers from October 1, 2012, to May 31, 2015. The researchers looked at BI-RADS assignment, and current and prior screening examination findings. Radiologists’ annual screening volumes, clinical experience, and concentration in breast imaging were calculated, and risk aversion, stress from uncertainty, and malpractice concerns were derived via survey.

The results showed that 5,678 of 61,198 screening examinations (9.3 percent) were recalled. Patient and radiologist characteristics associated with higher odds of recall included:

• Patient’s age younger than 50 years
• Prior mammographic findings
• Calcification
• Mass
• Higher density category
• Baseline examination
• Annual reading volume of fewer than 1,250 examinations
• Fewer than 10 years of experience

Radiologist’s risk aversion, stress from uncertainty, malpractice concerns, and cancer detection rates were not associated with higher recall rates.

The researchers concluded that interventions targeting radiologist factors may help reduce unwarranted variation in screening recall.