Inexperienced Radiologists Are Reading Your Mammograms

Inexperienced Radiologists Are Reading Your Mammograms

To be an expert, radiologists should be reading at least 750 mammograms a year.

The dreaded mammogram that women over 50 are recommended to have every other year is bad enough, but getting a call to return for more studies is really scary. On average, in the United States, one mammogram in 10 results in the patient being called back for further testing. A woman who gets 10 mammograms at an average testing site will have a 65% chance of being called back at least once because of what is called a false positive test result.

A woman who gets 10 mammograms at one of the more accurate testing sites will have a 40–50% chance of having at least one false positive test result. Each such false positive test involves a 30% chance of having a sonogram (ultrasound), a 30% chance of a repeated physical exam or surgical consultation, and a 30% chance of having a biopsy.

A false positive is a test result that was originally diagnosed as “suspicious” turns out to be negative. Many mammograms are read as “suspicious”, but only a small fraction of suspicious abnormalities on mammograms (5–10%) turn out to be breast cancer. Regardless, each suspicious mammogram requires a follow-up medical visit.

The false positive rate averages 5–15% at most mammography facilities in the United States. A few sites report rates much higher than this, upwards of 50%. Quality-of-care guidelines for mammography facilities recommend aiming for a callback rate of 5–10%.

To lower the risk of a false positive mammogram, have the test done at a location where a board-certified radiologist is present at all times and interprets the films as soon as they are taken. If the film is incomplete or fuzzy, the mammogram can be repeated immediately before the patient gets dressed and goes home. Most callbacks for abnormal mammograms result from a mistake made during the test procedure that made it impossible to read the mammogram.

Another way to lower the risk of a false positive mammogram is to locate a mammography facility where each film is read independently by two board-certified radiologists who limit their practice to breast imaging. When two highly experienced specialists agree that a spot or shadow on a mammogram film is worth closer attention, it probably is. Radiologists who specialize in reading mammograms can usually be found at academic medical centers.

Become active, not reactive, in your healthcare so you get the right care!**

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