Radiographer involvement in mammography image interpretation: A survey of United Kingdom practice

Abstract

Breast cancer is most often diagnosed using x-ray mammography. Traditionally mammography images have been interpreted and reported by medically qualified practitioners -radiologists. Due to radiologist workforce shortages in recent years some nonmedical practitioners, radiographers, now interpret and report mammography images. The aims of this survey were to describe the characteristics and practices of radiographers who interpret and report mammography images in NHS hospitals in the UK, and in particular to establish the extent of their practice beyond low-risk asymptomatic screening cases.This service evaluation demonstrated that UK radiographers are interpreting and reporting images across the full spectrum of clinical indications for mammography including: low-risk population screening, symptomatic, annual surveillance, family history and biopsy / surgical cases. The survey revealed that radiographers are involved in a diverse range of single and double reading practices where responsibility for diagnostic decision making is shared or transferred between radiologists and / or other radiographers. Comparative analysis of subgroup data suggested that there might be differences in the characteristics and practices of radiographers who interpret only low-risk screening mammograms and those who interpret and report a wider range of cases.The findings of this survey provide a platform for further research to investigate how and why the roles and responsibilities of radiographers who interpret and report mammograms vary between organisations, between practitioners and across different examinations. Further research is also needed to explore the implications of variation in practice for patients, practitioners and service providers. Highlights UK radiographers interpret mammograms across the full spectrum of clinical indications  UK radiographers are involved in a wide range of single / double mammography reading practices  Characteristics required for screen reading may differ from those for interpreting other cases  Further research is required to explore variation in practice across organisations and individuals  Further research is required to identify patient and service consequences of variation in practice

The role of the advanced clinical practitioner in breast diagnosis: A systematic review of the literature

“…the four-tier system 18 . Although multidisciplinary practice is a feature to an extent in all clinical environments, it was particularly apparent within breast clinics given the wide range of staff involved in the patient pathway 19,20 .Specifically, the included studies referred to breast care nurse specialists, pathologists, advanced nurse practitioners, advanced mammography practitioners, consultant radiographers, consultant radiologists, consultant breast surgeons and assistant practitioners as all being essential in the patient pathway 18,21,22,23 .…”

“…Furthermore, it was noted that multidisciplinary practice in breast imaging not only helped with sharing information and knowledge, but enabled staff to support each other. For example, studies found that multidisciplinary practice allowed extra flexibility within teams for training and development which improved patient pathways 22,23,24,25 . One way in which multidisciplinary practice allowed time for training and development was to more effectively allocate workloads.…”

“…Mammography image interpretation (MII) was the most commonly reported aspect of advanced practice in breast imaging. MII involves mammographers reporting mammograms to produce clinical reports and diagnosis 23 .…”

The Role of Deep Learning in Breast Screening

“…Gaining radiologist's acceptance that an automated independent reader is performing an analysis at or above human performance, which can be checked if necessary, will be an important step that has to be a high-priority focus area of work in the field. Indeed, there are already non-radiologist staff taking on the role of an independent reader, with many sites across the UK training and employing consultant mammographers in order to bolster their workforce [33], as such, there is already a move, driven by necessity, towards non-radiologist interpretation of images.…”

A self-directed learning intervention for radiographers rating mammographic breast density

“…In the United Kingdom (UK), radiographers are heavily involved in screening mammography interpretation and imaging decision-making. 17 Although advanced practitioner and consultant radiographers' cancer detection performance in mammography interpretation is comparable to radiologists, 18 there is no data regarding their knowledge and inter-reader agreement in MBD assessment. Also, no study has assessed MBD agreement between radiographers and radiologists as well as other established MBD assessment approaches such as Volpara TM .…”