Mammography screening — reasons for recall and the influence of experience on recall in the finnish system

The use of additional imaging increased specificity and decreased sensitivity in screening mammography

“…Several studies have shown that increased mammography experience and training [4,46], and being a mammography specialist improved accuracy [9]. This type of research may help optimize the use of additional imaging but was beyond the scope of our study.…”

“…Many of the other studies to assess the use of additional imaging were done with symptomatic women or a combination of asymptomatic and symptomatic women and looked at the value of additional imaging with either a test set or as a retrospective review of specific cases [4,[37][38][39][40]. Most of the studies looked at the added value of ultrasound for detecting cancers, without looking at negative assessments or the effect of additional imaging on specificity.…”

“…Many other countries have a much lower recall rate than the United States [4,[6][7][8]. In The Netherlands the referral rate is under 2% for initial screens, and is lower for subsequent screening examinations [7], while in Finland [4] and in the United Kingdom [6] the recall rate is 3.2 and 7.4%, respectively, for initial mammograms. However, definitions of recall in the literature are not necessarily the same, making comparisons difficult [8].…”

“…The use of additional imaging to augment the standard screening views varies [4]. The American College of Radiology has suggested that less than 10% of women should be recalled for additional imaging [3].…”

“…Within the United States the recall rates among mammography facilities has varied by as much as 11% (range 1.9-13.4) [5], and has recently been reported to average 13.1% for initial mammograms and 8% for subsequent mammograms [6]. Many other countries have a much lower recall rate than the United States [4,[6][7][8]. In The Netherlands the referral rate is under 2% for initial screens, and is lower for subsequent screening examinations [7], while in Finland [4] and in the United Kingdom [6] the recall rate is 3.2 and 7.4%, respectively, for initial mammograms.…”