Detecting Breast Cancer
Posted by
Dan FrithDecember 12, 2007 2:16 PMWe all know how important it is to detect breast cancer early before it metastasizes into surrounding tissue. Frankly put, the earlier the diagnosis ...the earlier the treatment...the greater the likelihood of a good outcome! One tool used by doctors to make that early diagnosis is the mammogram. The scary part of the story is how frequently doctors (radiologists) misread this diagnostic study!
In an article published in this week's Journal of the National Cancer Institute we learn of a study in which many radiologist just plan got it wrong! The study examined the performance of 123 radiologists who interpreted nearly 36,000 diagnostic mammograms from 1996 to 2003 at 72 U.S. facilities. All the mammograms had been ordered for women who found a lump themselves or whose doctors discovered something of concern.
The study revealed the radiologists' ability to detect cancer (when it was present) ranged from 27 percent to 100 percent, with a median of 79 percent. This means that doctors reading mammograms miss an average of 2 in every 10 cases of breast cancer, even for women with lumps and other symptoms!
The radiologists who were most accurate tended to be those based at academic medical centers, followed by those who spent at least 20 percent of their time on breast imaging. Unfortunately, the vast majority of mammograms are read by general radiologists in the community not by specialists at academic centers. In the current study, one-quarter of the radiologists read fewer than 1,000 mammograms a year.
So where does this leave us? First, just because you have a mammogram which has been interpreted to be free of cancer...you may still have breast cancer. A definitive diagnosis of cancer depends on a biopsy. Secondly, if there is any question about the interpretation of your mammogram...get it read a second time by a radiologist who reads mammograms daily and who practices at an academic center.