Evaluation of radiographers’ mammography screen‐reading accuracy in Australia

Abstract

Abstract Introduction This study aimed to evaluate the accuracy of radiographers’ screen‐reading mammograms. Currently, radiologist workforce shortages may be compromising the BreastScreen Australia screening program goal to detect early breast cancer. The solution to a similar problem in the United Kingdom has successfully encouraged radiographers to take on the role as one of two screen‐readers. Prior to consideration of this strategy in Australia, educational and experiential differences between radiographers in the United Kingdom and Australia emphasise the need for an investigation of Australian radiographers’ screen‐reading accuracy. Methods Ten radiographers employed by the Westmead Breast Cancer Institute with a range of radiographic (median = 28 years), mammographic (median = 13 years) and BreastScreen (median = 8 years) experience were recruited to blindly and independently screen‐read an image test set of 500 mammograms, without formal training. The radiographers indicated the presence of an abnormality using BI‐RADS®. Accuracy was determined by comparison with the gold standard of known outcomes of pathology results, interval matching and client 6‐year follow‐up. Results Individual sensitivity and specificity levels ranged between 76.0% and 92.0%, and 74.8% and 96.2% respectively. Pooled screen‐reader accuracy across the radiographers estimated sensitivity as 82.2% and specificity as 89.5%. Areas under the reading operating characteristic curve ranged between 0.842 and 0.923. Conclusions This sample of radiographers in an Australian setting have adequate accuracy levels when screen‐reading mammograms. It is expected that with formal screen‐reading training, accuracy levels will improve, and with support, radiographers have the potential to be one of the two screen‐readers in the BreastScreen Australia program, contributing to timeliness and improved program outcomes.

Keywords

• Accuracy
• image interpretation
• mammogram
• radiographer
• screen‐reading