High-Volume Radiologists Detect More Breast Cancers

Radiologists who perform the most mammograms find cancer more frequently and order fewer biopsies, according to a report published in the Journal of National Cancer Institute.

The findings suggest that countries like the United Kingdom where each radiologist is required to read at least 5,000 mammograms a year achieve better diagnostic results than countries like the United States, where only an annual total of 480 mammograms is required.

In the study, U.S. doctors were divided into three groups: 18 high-volume doctors who evaluated 301 or more films monthly; 22 medium-volume practitioners who viewed 101 to 300 films monthly; and 19 low-volume doctors who saw 100 or fewer films a month.

The U.S. doctors and a group of British doctors, who typically view more than 400 films per month, were each asked to interpret 60 mammograms, 13 of which contained cancer.

Dr. Laura Esserman of the University of California said British doctors had an accuracy rate of 78.5 percent.

She said the high-volume American doctors had an accuracy rate of 75.6 percent, medium-volume American radiologists had an accuracy rate of 70.2 percent, and low-volume American doctors had a rate of 64.8 percent.

A lower accuracy, according to Esserman, meant more patients had unnecessary biopsies and more cancers went undetected.

"Our finding that higher volume improves diagnostic performance suggests that there may be an opportunity to improve quality and efficiency by re-engineering the organization of U.S. mammography screening programs," the researchers concluded.

Other Sources: Journal of the National Cancer Institute