National Performance Benchmarks for Modern Screening Digital Mammography: Update from the Breast Cancer Surveillance Consortium.
Level 3 - non-randomized controlled study
Multi-center observational registry cohort study evaluating screening performance metrics.
PubMed 27918707 · doi:10.1148/radiol.2016161174
What was done
Performance metrics for digital screening mammography were evaluated among 359 radiologists across 95 facilities in six Breast Cancer Surveillance Consortium (BCSC) registries between 2007 and 2013. The study included 1,682,504 digital screening mammograms in 792,808 women. Performance measures were calculated using American College of Radiology BI-RADS 5th edition criteria and compared with published benchmarks and expert recommendations.
What was found
Mean performance measures were: abnormal interpretation rate (AIR) of 11.6% (95% CI: 11.5–11.6); cancer detection rate (CDR) of 5.1 per 1,000 screens (95% CI: 5.0–5.2); sensitivity of 86.9% (95% CI: 86.3–87.6%); specificity of 88.9% (95% CI: 88.8–88.9%); false-negative rate of 0.8 per 1,000 screens (95% CI: 0.7–0.8); PPV1 of 4.4% (95% CI: 4.3–4.5%); PPV2 of 25.6% (95% CI: 25.1–26.1%); and PPV3 of 28.6% (95% CI: 28.0–29.3%). Of detected cancers, 76.9% were stage 0 or 1, 57.7% were minimal, and 79.4% were node-negative invasive cancers. While 92.1% and 97.1% of radiologists achieved recommended CDRs and sensitivity, only 59.0% achieved recommended AIRs and 63.0% achieved recommended specificity.
Why it matters
This study provides updated national benchmarks for digital mammography in community practice. It demonstrates high sensitivity and cancer detection rates nationwide, while identifying high recall rates as an ongoing area for quality improvement.
Limits
The abstract does not provide subgroup analyses by age, race/ethnicity, or breast density, nor does it account for radiologist reading volume or facility characteristics. Long-term clinical endpoints such as mortality reduction or overdiagnosis were not measured.
Cited by
- supports Mammography has an approximate sensitivity of 90% and specificity of 85%.