Does Practice Make Perfect When Interpreting Mammography?

Abstract

There are important trade-offs in the practice of interpreting mammography. Radiologists do not want to miss identifying breast cancer, yet performing additional imaging to rule out cancer increases false-positive rates. False-positive mammo-grams generate anxiety, excess costs and, at times, morbidity from subsequent biopsies. The false-positive rate for screening mammography is higher in the United States than in European countries. Reducing the false-positive rates and maintaining high levels of sensitivity, as suggested by Esserman et al. (1) in this issue of the Journal, is appealing. They hypothesize that inter-preting a high volume of mammograms, as is the norm for radiologists in the U.K., results in higher sensitivity than inter-preting a low volume, as is often the norm for some U.S. radi-ologists. In their study (1), a standardized test set of 60 screening films from asymptomatic women, 13 of which included nonoc-

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