Simple Interventions Decrease Screening Mammography Recall Rates

Implementing simple interventions could significantly decrease screening mammography recall rates.

Simple interventions may reduce recall rates for women undergoing full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT), according to a study published in Academic Radiology.

Researchers from Johns Hopkins University School of Medicine in Baltimore, MD, and Columbia University in New York City, wanted to determine the impact of interventions designed to reduce screening mammography recall rates on screening performance metrics.

The researchers assessed the baseline performance for FFDM and DBT for a 3-year period before intervention, and sought to increase awareness of recalls from screening mammography. The first intervention included breast imagers discussing their perceptions regarding screening recalls and were required to review their own recalled cases, including outcomes of diagnostic evaluation and biopsy. The second intervention implemented consensus double reading of all recalls, requiring two radiologists to agree if recall was necessary. Recall rates, cancer detection rates, and positive predictive value 1 (PPV1) were compared before and after each intervention.

The results showed a significant change in recall rates after the intervention:

 BaselineIntervention 1 (Awareness)Intervention 2 (Consensus)
Recall rateFFDM - 11.1%; DBT - 7.6%FFDM – 9.2%; DBT – 6.6%FFDM – 9.9%; DBT – 7.2%
Cancer detection rate (per 1,000)FFDM – 3.8; DBT – 4.8FFDM – 3.1; DBT – 6.2FFDM – 5.9; DBT – 5.7
PPVIFFDM – 3.4%; DBT – 6%FFDM – 3.1%; DBT – 10.8%FFDM – 5.7%; DBT – 9%td>






Cancer detection rate did not significantly change with the implementation of these interventions. An average of 2.3 minutes was spent consulting for each recall.

The researchers concluded that their interventions improved performance and could be implemented in other breast imaging settings.