Radiologists report fewer false positives when they have access to prior mammograms
Having access to patients’ prior mammograms provides a significantly better screening experience for women.
A new study published in Clinical Radiology details numerous benefits of radiologists having patients’ previous mammograms to compare to their updated exams. Having such access can both reduce false positives and improve specificity, ultimately reducing the number of women recalled for additional imaging or procedures.
The digitization of medical records and imaging storage has made prior imaging more readily available for radiologists to review. However, comparing patients’ current imaging to prior studies is time consuming, increases readers’ workloads and may not be feasible for every provider. As such, it's important to understand whether the additional work yields worthwhile results.
Researchers sought to determine whether certain reader or patient factors would affect the benefits of routinely viewing prior imaging. To do this, they had eight radiologists independently evaluate 72 digital screening mammograms in two reading sessions six months apart. Patients’ prior imaging was available during the first interpretations, but radiologists only had access to current mammograms for the second read.
The team compared the specificity, sensitivity and lesion sensitivity for readers with and without access to priors and also took note of how breast density and radiologist experience level affected performance.
Having access to prior mammograms improved both specificity and false positive rates in dense and non-dense breasts. It also reduced the probability of false positives without affecting false negative or detection rates, the authors noted.
Viewing previous imaging consistently improved readers performances, regardless of their experience level, specialization or the volume of screening mammograms they were accustomed to reading.
“Comparison with prior mammograms should help radiologists detect changes in mammographic features that are most discriminative of breast cancer,” Judith D. Akwo, from the Medical Image Optimization and Perception Group at Sydney School of Health Sciences in Austrailia, and co-authors wrote. “These findings are relevant because they suggest that viewing prior mammograms can improve the efficiency of screening programs by ensuring that women who have no cancer are correctly informed thereby reducing unnecessary recall and testing.”
The group suggested that their findings support enacting policies that require facilities to always retain patients’ screening mammograms for the sake of future comparison. While there are logistics to consider alongside such policies—like archiving capacity, costs and workload considerations—the group maintained that “the utility of prior mammograms in reducing false positives, which mitigates psychosocial harms and cost of assessments for women wrongly recalled," should be emphasized.
“The simultaneous display of prior and current mammograms may be a useful strategy to improve the efficiency of screening programs by reducing the number of women who are incorrectly called back to assessment clinics,” the authors concluded.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.