Mammography Clinical Image Quality and the False Positive Rate in a Canadian Breast Cancer Screening Program

Abstract

Artifacts can have a substantial effect on the FP rate. The effect of overall mammography quality on the FP rate may also be substantial and needs to be clarified.

Consensus about image quality assessment criteria of breast implants mammography using Delphi method with radiographers and radiologists

“…Major differences in agreement were related to the priority of criteria, with radiographers searching for specific anatomical details (nipple in profile, visualisation of medial, superior and inferior breast tissues), while radiologists were focused on overall assessment such as contrast, breast aligned with the detector, beam penetration, spread and sharpness of breast tissue and absence of artefacts. In a study promoted by the Canadian Association of Radiologists [49], the problems related to the presence of artefacts in the image were emphasised as they can promote an increase in false positive rates compromising the diagnosis. On the other hand, another study stressed positioning deficiencies as the main causes of inadequate image quality.…”

Evaluation of the quality of mammographic breast positioning: a quality improvement study

“…In these studies, improper breast positioning was the most common factor affecting the quality of mammographic examinations, with failure rates of 22.6%, 37.2% and 55.0%, respectively. 5,8,19 There is some evidence suggesting that quality monitoring of mammographic examinations and up-to-date positioning training, rather than the technologist's years of experience, lead to higher quality images. In a Dutch study, newly trained technologists were more likely to demonstrate adequate breast positioning than experienced technologists (97% v. 86%, respectively, for CC views and 92% v. 84%, respectively, for MLO views).…”

“…2,3 Improper breast positioning can also decrease the diagnostic sensitivity of mammography, potentially leading to unnecessary repeat examinations, higher radiation exposure, unnecessary invasive procedures such as biopsies and surgery, and missed breast cancer cases. [4][5][6][7] In recent years, there have been increasing concerns regarding the quality of breast positioning in mammographic examinations. 4,[8][9][10] In Canada, a study evaluated the quality of 197 mammographic examinations performed between 2004 and 2005 as part of the Quebec Breast Cancer Screening Program.…”

Clinical Image Quality and Sensitivity in an Organized Mammography Screening Program

“…Clinical mammography quality is widely believed to influence sensitivity and specificity of breast cancer screening but few studies have examined these associations. One study suggested that lower overall clinical quality could be associated with an increase in the falsepositive rate, with artifacts being associated with a 2fold increase in the false-positive rate [9]. Only 1 study assessed the relation of screening mammogram quality to sensitivity and this study observed that lower quality of positioning was associated with a reduced screening sensitivity for women screened between 1988-1993 [10].…”