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The accuracy of diagnostic mammograms varies according to radiologist, with doctors missing on average 20 percent of breast cancer diagnoses and some as many as 70 percent, a new study shows.

“Women think mammography is perfect, so if they get a negative [normal] mammogram, they think they’re safe for at least the next year. The reality is, they shouldn’t be falsely reassured by a negative mammogram,” said lead author of the study, Diana Miglioretti.

Little Known about Diagnostic Mammograms
Prior to this study, which is published in the Journal of the National Cancer Institute, researchers knew little about the accuracy of diagnostic mammograms, which are used to detect or rule out cancer in symptomatic patients.

For this study, Miglioretti and her colleagues at Group Health Center for Health Studies in Seattle reviewed the results of nearly 36,000 diagnostic mammograms interpreted by 123 radiologists across the U.S. between 1996 and 2003.

Study Findings
All of the women who received the mammograms had a suspicious lump or something else of concern. In women who actually had cancer, the accuracy rate of detection ranged from 27 to 100 percent with 79 percent being the median.

The rate of false positives—that is, cancer diagnoses when cancer is not actually present—ranged from zero to16 percent with a 4.3 percent median.

According to the study findings, radiologists at academic medical centers and those who specialize in breast imaging had greater accuracy than non-specialists, but still only had an accuracy rate of 88 percent.

In the U.S., most mammograms are interpreted by general radiologists, not specialists.

“A lot of American women can’t see a breast imaging specialist, especially in rural areas,” Miglioretti said.

The Bottom Line
Dr. Leonard Berlin, chief of radiology at Rush North Medical Center, cautioned patients with symptoms against being reassured by a negative mammogram.

“You can have cancer and still have a normal mammogram. If you have any sign or symptom, you need to pursue it. That’s the bottom line,” Berlin said.

(Source: Chicago Tribune online)

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