The relationship between missed breast cancers on mammography in a test-set based assessment scheme and real-life performance in a National Breast Screening Programme

Yan Chen*, Jonathan J. James, Eleni Michalopoulou, Iain T. Darker, Jacquie Jenkins

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Purpose: This retrospective study determined whether a test-set based assessment scheme (PERFORMS) used in a national breast screening programme could be used to predict real-life performance by investigating if the number of cancers missed by mammography readers in real-life related to the number of cancers missed in the PERFORMS test-set and whether real-life reading volumes affected performance. 

    Method: Data was obtained from consenting readers in the screening programme in England (NHSBSP) where double reading is standard. The rate of cancers missed by individual first readers but correctly identified by second readers was compared with the number of cancers missed in the PERFORMS test-set over a 3-year period. NHSBSP readers are required to interpret at least 1500 cases per year as a first reader, so results were compared between readers who exceeded this target and those that did not. Parametric and non-parametric correlations were calculated. 

    Results: Amongst the 536 readers, there was a highly significant positive correlation between the real-life and PERFORMS test-set missed cancer metrics (Pearson Correlation = 0.228, n = 536, p < .0001, Spearman's rho = 0.265, n = 536, p < .0001). There was no significant difference in rates of missed cancers between the 452 readers who exceeded the 1500 first read per year target and those who did not (t(94.2) = −1.87, p = .0643, r = 0.19). 

    Conclusions: The use of a test-set based assessment scheme accurately reflects real-life mammography reading performance, indicating that it can be a useful tool in identifying poor reader performance.

    Original languageEnglish
    Article number109881
    JournalEuropean Journal of Radiology
    Volume142
    Early online date28 Jul 2021
    DOIs
    Publication statusPublished - Sept 2021

    Bibliographical note

    Funding Information: The PERFORMS test scheme was funded by Public Health England, Breast Screening Programme. The funding source had no level of involvement in this study.

    Open Access: No Open Access licence.

    Publisher Copyright: Crown Copyright © 2021 Published by Elsevier B.V. All rights reserved.

    Citation: Yan Chen, Jonathan J. James, Eleni Michalopoulou, Iain T. Darker, Jacquie Jenkins, The relationship between missed breast cancers on mammography in a test-set based assessment scheme and real-life performance in a National Breast Screening Programme, European Journal of Radiology, Volume 142, 2021, 109881, ISSN 0720-048X.

    DOI: https://doi.org/10.1016/j.ejrad.2021.109881.

    Keywords

    • Breast cancer
    • Mammography
    • Performance
    • Screening

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