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Medical Radiologic Technologist Review: Effects on a Population-based Breast Cancer Screening Program¹

¹ From the Saskatchewan Cancer Agency, Epidemiology, Prevention and Screening, 4101 Dewdney Ave, Regina, Saskatchewan, Canada S4T 7T1. Received March 26, 1998; revision requested May 12; final revision received August 17; accepted October 26. Address reprint requests to J.M.T.

PURPOSE: To evaluate the effects of medical radiologic technologist review of mammograms in a population-based breast cancer screening program.

MATERIALS AND METHODS: A technologist review pilot project was incorporated into the Regina, Saskatchewan, Canada, reading center. Technologists received special training in mammographic interpretation. They reviewed all 27,863 mammograms obtained at the center from July 1995 to September 1996 that were reviewed by a radiologist and selected cases for second blind reading by another radiologist. When the two radiologists' readings were in agreement, the report was sent. When the readings differed, a third opinion was obtained from the program's consulting radiologist. Changes in the number of mammograms interpreted as abnormal and the number of cancers detected were assessed.

RESULTS: The technologist review was responsible for the detection of nine cancers missed at the first radiologist's interpretation. Technologists were very discriminating; only 391 cases (1.4%) were sent for double reading. The positive predictive value of screening did not change significantly (7.5% without review, 8.1% with review; P > .20).

CONCLUSION: A substantial number of cancers were found with the technologist review. The number of mammograms interpreted as abnormal was reduced slightly. The technologist review proved to be a cost-effective alternative to double reading by two radiologists.

Index terms: Breast neoplasms, diagnosis, 00.11, 00.30 • Cancer screening, 00.11, 00.30 • Diagnostic radiology, observer performance

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