Mammographic feature type and reader variability by occupation - an ROC study

Previous work has outlined that certain mammographic appearances feature more prominently in reader’s false negative responses on a self-assessment scheme. Bi-annually 600 breast-screening film-readers complete at least one round of the Personal Performance in Mammographic Screening (PERFORMS) self-assessment scheme in the UK. The main occupational groups in UK Breast Screening can be categorised thus, Radiologist, Technologists and Symptomatics. Previous work has shown that these groups can vary in their reading ‘style’ and accuracy on self-assessed cases. These groups could be said to contain individuals each with (arguably) pronounced differences in their real life reading experience, symptomatic readers routinely read a large number of cases with abnormal appearances and Technologists (specially trained to read films) do not have the same medical background as breast-screening Radiologists. We aimed to examine overall (national) and group (occupational) differences in terms of ROC analysis on those mammographic cases with different mammographic appearance (feature type). Several main feature types were identified namely; Well Defined Mass (WDM), Ill Defined Mass (IDM), Spiculate Mass (SPIC), Architectural Distortions (AD), Asymmetry (ASYM) and Calcification (CALC). Results are discussed in light of differences in real-life practice for each of the occupational groups and how this may impact on accuracy over certain mammographic appearances.