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Performance Benchmarks for Screening Mammography¹

¹ From the Department of Radiology, University of New Mexico Health Sciences Center, MSC10 5530, 1 University of New Mexico, Albuquerque, NM 87131 (R.D.R.); Department of Radiology, University of North Carolina, Chapel Hill, NC (B.C.Y.); Group Health Center for Health Studies, Seattle, Wash (L.A.A., D.S.M.B., W.E.B.) and Cancer Research and Biostatistics (W.E.B.), Seattle, Wash; Department of Radiology, University of California San Francisco School of Medicine, San Francisco, Calif (E.A.S.); Department of Radiology, University of Washington Medical Center, Seattle, Wash (C.D.L.); Office of Health Promotion Research (B.M.G., D.L.W.), Department of Pathology (D.L.W.), and Vermont Cancer Center (B.M.G., D.L.W.), University of Vermont, Burlington, Vt; Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH (P.A.C.); General Internal Medicine Section, Departments of Veterans Affairs and Epidemiology and Biostatistics, University of California, San Francisco, Calif (K.K.); and Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Md (R.B.). Received September 7, 2005; revision requested November 10; revision received January 7, 2006; final version accepted February 1. Supported by cooperative grants U0169976 (R.D.R.), U01CA70040 (B.C.Y.), U01CA63740 (E.A.S., K.K.), U01CA70013 (B.M.G., D.L.W.), U01CA86076 (L.A.A., W.E.B.), U01CA63731 (D.S.M.B.), and U01CA86082-01 (P.A.C.) from the National Cancer Institute. Address correspondence to R.D.R. (e-mail: rrosenb{at}unm.edu).

View larger version (9K): [in this window] [in a new window] [Download PPT slide]   Figure 1a: Smoothed plots of frequency distributions for recall rates and PPVs. Overlaid solid line indicates 50th percentile (median), paired dashed lines indicate 25th and 75th percentiles, and paired dotted lines indicate 10th and 90th percentiles. (a) Recall rate for 2 076 379 examinations among 344 radiologists with 1000 or more examinations. (b) PPV1 for 195 591 abnormal interpretations among 330 radiologists with 100 or more abnormal interpretations. (c) PPV2 for 27 947 abnormal interpretations among 256 radiologists with 30 or more biopsy recommendations. (d) PPV3 for 18 948 abnormal interpretations among 195 radiologists with 30 or more biopsies performed. The corresponding mean values for all 2 580 151 examinations are in Table 3.

View larger version (9K): [in this window] [in a new window] [Download PPT slide]   Figure 1b: Smoothed plots of frequency distributions for recall rates and PPVs. Overlaid solid line indicates 50th percentile (median), paired dashed lines indicate 25th and 75th percentiles, and paired dotted lines indicate 10th and 90th percentiles. (a) Recall rate for 2 076 379 examinations among 344 radiologists with 1000 or more examinations. (b) PPV1 for 195 591 abnormal interpretations among 330 radiologists with 100 or more abnormal interpretations. (c) PPV2 for 27 947 abnormal interpretations among 256 radiologists with 30 or more biopsy recommendations. (d) PPV3 for 18 948 abnormal interpretations among 195 radiologists with 30 or more biopsies performed. The corresponding mean values for all 2 580 151 examinations are in Table 3.

View larger version (10K): [in this window] [in a new window] [Download PPT slide]   Figure 1c: Smoothed plots of frequency distributions for recall rates and PPVs. Overlaid solid line indicates 50th percentile (median), paired dashed lines indicate 25th and 75th percentiles, and paired dotted lines indicate 10th and 90th percentiles. (a) Recall rate for 2 076 379 examinations among 344 radiologists with 1000 or more examinations. (b) PPV1 for 195 591 abnormal interpretations among 330 radiologists with 100 or more abnormal interpretations. (c) PPV2 for 27 947 abnormal interpretations among 256 radiologists with 30 or more biopsy recommendations. (d) PPV3 for 18 948 abnormal interpretations among 195 radiologists with 30 or more biopsies performed. The corresponding mean values for all 2 580 151 examinations are in Table 3.

View larger version (10K): [in this window] [in a new window] [Download PPT slide]   Figure 1d: Smoothed plots of frequency distributions for recall rates and PPVs. Overlaid solid line indicates 50th percentile (median), paired dashed lines indicate 25th and 75th percentiles, and paired dotted lines indicate 10th and 90th percentiles. (a) Recall rate for 2 076 379 examinations among 344 radiologists with 1000 or more examinations. (b) PPV1 for 195 591 abnormal interpretations among 330 radiologists with 100 or more abnormal interpretations. (c) PPV2 for 27 947 abnormal interpretations among 256 radiologists with 30 or more biopsy recommendations. (d) PPV3 for 18 948 abnormal interpretations among 195 radiologists with 30 or more biopsies performed. The corresponding mean values for all 2 580 151 examinations are in Table 3.

View larger version (10K): [in this window] [in a new window] [Download PPT slide]   Figure 2a: Smoothed plots of frequency distributions for detected cancers. Overlaid solid line indicates 50th percentile (median), paired dashed lines indicate 25th and 75th percentiles, and paired dotted lines indicate 10th and 90th percentiles. (a) Cancer detection rate for 2 076 379 examinations among 344 radiologists with 1000 or more examinations. (b) Mean cancer size for 5424 invasive cancers with known size among 159 radiologists with detection of 15 or more invasive cancers with known size. (c) Percentage of minimal cancer for 7689 cancers among 190 radiologists with detection of 15 or more cancers. (d) Percentage of node-negative cancers for 5753 invasive cancers with known nodal status among 169 radiologists with detection of 15 or more invasive cancers with known nodal status. (e) Percentage of stage 0 or I cancers for 7268 cancers with known stage among 182 radiologists with detection of 15 or more cancers with known stage. The corresponding mean values for all 2 580 151 examinations and 12 068 cancers are in Table 4.

View larger version (10K): [in this window] [in a new window] [Download PPT slide]   Figure 2b: Smoothed plots of frequency distributions for detected cancers. Overlaid solid line indicates 50th percentile (median), paired dashed lines indicate 25th and 75th percentiles, and paired dotted lines indicate 10th and 90th percentiles. (a) Cancer detection rate for 2 076 379 examinations among 344 radiologists with 1000 or more examinations. (b) Mean cancer size for 5424 invasive cancers with known size among 159 radiologists with detection of 15 or more invasive cancers with known size. (c) Percentage of minimal cancer for 7689 cancers among 190 radiologists with detection of 15 or more cancers. (d) Percentage of node-negative cancers for 5753 invasive cancers with known nodal status among 169 radiologists with detection of 15 or more invasive cancers with known nodal status. (e) Percentage of stage 0 or I cancers for 7268 cancers with known stage among 182 radiologists with detection of 15 or more cancers with known stage. The corresponding mean values for all 2 580 151 examinations and 12 068 cancers are in Table 4.

View larger version (10K): [in this window] [in a new window] [Download PPT slide]   Figure 2c: Smoothed plots of frequency distributions for detected cancers. Overlaid solid line indicates 50th percentile (median), paired dashed lines indicate 25th and 75th percentiles, and paired dotted lines indicate 10th and 90th percentiles. (a) Cancer detection rate for 2 076 379 examinations among 344 radiologists with 1000 or more examinations. (b) Mean cancer size for 5424 invasive cancers with known size among 159 radiologists with detection of 15 or more invasive cancers with known size. (c) Percentage of minimal cancer for 7689 cancers among 190 radiologists with detection of 15 or more cancers. (d) Percentage of node-negative cancers for 5753 invasive cancers with known nodal status among 169 radiologists with detection of 15 or more invasive cancers with known nodal status. (e) Percentage of stage 0 or I cancers for 7268 cancers with known stage among 182 radiologists with detection of 15 or more cancers with known stage. The corresponding mean values for all 2 580 151 examinations and 12 068 cancers are in Table 4.

View larger version (9K): [in this window] [in a new window] [Download PPT slide]   Figure 2d: Smoothed plots of frequency distributions for detected cancers. Overlaid solid line indicates 50th percentile (median), paired dashed lines indicate 25th and 75th percentiles, and paired dotted lines indicate 10th and 90th percentiles. (a) Cancer detection rate for 2 076 379 examinations among 344 radiologists with 1000 or more examinations. (b) Mean cancer size for 5424 invasive cancers with known size among 159 radiologists with detection of 15 or more invasive cancers with known size. (c) Percentage of minimal cancer for 7689 cancers among 190 radiologists with detection of 15 or more cancers. (d) Percentage of node-negative cancers for 5753 invasive cancers with known nodal status among 169 radiologists with detection of 15 or more invasive cancers with known nodal status. (e) Percentage of stage 0 or I cancers for 7268 cancers with known stage among 182 radiologists with detection of 15 or more cancers with known stage. The corresponding mean values for all 2 580 151 examinations and 12 068 cancers are in Table 4.

View larger version (9K): [in this window] [in a new window] [Download PPT slide]   Figure 2e: Smoothed plots of frequency distributions for detected cancers. Overlaid solid line indicates 50th percentile (median), paired dashed lines indicate 25th and 75th percentiles, and paired dotted lines indicate 10th and 90th percentiles. (a) Cancer detection rate for 2 076 379 examinations among 344 radiologists with 1000 or more examinations. (b) Mean cancer size for 5424 invasive cancers with known size among 159 radiologists with detection of 15 or more invasive cancers with known size. (c) Percentage of minimal cancer for 7689 cancers among 190 radiologists with detection of 15 or more cancers. (d) Percentage of node-negative cancers for 5753 invasive cancers with known nodal status among 169 radiologists with detection of 15 or more invasive cancers with known nodal status. (e) Percentage of stage 0 or I cancers for 7268 cancers with known stage among 182 radiologists with detection of 15 or more cancers with known stage. The corresponding mean values for all 2 580 151 examinations and 12 068 cancers are in Table 4.