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JNCI Journal of the National Cancer Institute 2002 94(5):321-323; doi:10.1093/jnci/94.5.321
© 2002 by Oxford University Press
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Journal of the National Cancer Institute, Vol. 94, No. 5, 321-323, March 6, 2002
© 2002 Oxford University Press

EDITORIAL

Does Practice Make Perfect When Interpreting Mammography?

Joann G. Elmore, Patricia A. Carney

Affiliations of authors: J. G. Elmore, Department of Medicine, University of Washington School of Medicine, Seattle, WA; P. A. Carney, Community and Family Medicine, Dartmouth Medical School and Norris Cotton Cancer Center, Hanover/Lebanon, NH.

Correspondence to: J. Elmore, M.D., Harborview Medical Center, 325 Ninth Ave., Box 359780, Seattle, WA 98104–2499 (e-mail: jelmore@u.washington.edu).

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 mammograms 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 interpreting a high volume of mammograms, as is the norm for radiologists in the U.K., results in higher sensitivity than interpreting a low volume, as is often the norm for some U.S. radiologists. In their study (1), a standardized test set of 60 screening films from asymptomatic women, . . . [Full Text of this Article]

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