March 16, 2017 — Solis Mammography recently released a statement taking issue with incorrectly interpreted terminology used by reporters and others referring to a mammogram callback as a “false positive.” As evidence, the statement highlighted a study published Feb. 9 in the journal Cancer Epidemiology, Biomarkers & Prevention that referred to mammography recalls as false positive mammograms. This led to news reports across the country stating that a false positive was defined as “a doctor telling a woman that cancer is present, but it turns out not to be.” Solis Mammography said this is more than a simple misspeak on the part of a reporter. It’s a common misunderstanding and is blatantly false.
After a woman has completed her annual well woman mammogram (2-D or 3-D), the images are viewed and interpreted by a radiologist with about 90 percent of all screenings being negative for breast issues, if read by a specialized breast radiologist. However, if the radiologist can not see something clearly (sometimes due to dense breast tissue) or sees something that they feel needs a second look, the radiologist will ask the patient to return for more tests, otherwise known as a callback. The radiologist is not saying the first mammogram was a positive indicator for cancer. Rather, he/she is simply stating the need for a closer look — a more magnified view of a particular area (a diagnostic mammogram) — in order to make an accurate recommendation/diagnosis.
Of the small percentage of patients who are called back, on average only 10 percent of those callbacks result in the need for further testing like an ultrasound or biopsy. And even if no additional tests are needed, the recall may simply identify an area that needs observation year over year as a woman’s breast tissue experiences natural changes.
“A callback does not mean a positive finding of cancer,” said James Polfreman, president and CEO, Solis Mammography. “A ‘false positive’ result is medical jargon. Those in the healthcare community understand what it means, but someone unfamiliar with the clinical definition is easily misled to assume it means a misdiagnosis of cancer. Understanding that too many women already avoid mammograms because of fear and anxiety, the term ‘false positives’ should cease to be used in order to help educate women about the importance of regular, annual screening – even when it might result in a callback for additional views.”
Clinical research, as published in Radiology, shows there is a significant difference in mammography accuracy between general radiologists and those who specialize in breast imaging. Mammography is most accurate when performed in a breast center with fellowship-trained, specialized breast radiologists; by radiologists who read a high volume of both screening and diagnostic mammograms; and by facilities who employ “batch reading” to interpret screening mammograms without interruption.1 Of the approximately 27,000 radiologists in the U.S., less than 5 percent (or 1,350) meet this standard of mammography focus.2
A specialized breast radiologist typically delivers patients a recall rate substantially lower than that of a generalist radiologist. While the national recall rate for a 2-D screening mammogram is on average 10 to 13 percent, at breast-dedicated centers like Solis Mammography, recall rates are much lower – less than 8 percent on average with no change in cancer detection rates.
In 2013, peer-reviewed research, co-authored by Solis Mammography Chief Medical Officer Stephen Rose, M.D., demonstrated that 3-D mammography (also known as tomosynthesis) increased early detection of breast cancer by 54 percent and reduced recall rates by 37 percent. That 37 percent decrease in callbacks saves patients time and money, but more importantly, reduces unnecessary stress and anxiety. This is a key reason why Solis Mammography has invested more than $18 million since 2014 to upgrade all of their centers to offer 3-D mammography.
Dense breast tissue impacts a patient’s recall percentage. 3-D mammography is substantially better at screening dense breast tissue than 2-D mammography. Women who have denser breast tissue tend to be younger. Dense breast tissue tends to have less fatty tissue and more non-fatty (milk glands, milk ducts and supportive tissue). Fatty tissue appears gray, while dense glandular tissue and breast cancer appear white on a mammogram. By providing the equivalent of 60 1-inch “slices” of breast tissue views, 3-D mammography helps radiologists better differentiate a problematic mass from simple overlying glandular tissue.
Solis Mammography provided several tips that healthcare professionals can share with their patients to minimize recall statistics:
- Opt for a 3-D versus 2-D screening mammogram. While studies have proven that all women can greatly benefit from 3-D mammography, it is especially helpful if a patient has presented with dense breast tissue, has a strong family history of breast cancer or has previously experienced frequent callbacks.
- Choose a breast center instead of a general imaging center.
- Ask the radiologist reading the mammogram, and the technologists performing the compression, if they are breast-imaging specialists. This expertise makes a big difference in accurate diagnoses and minimizes unnecessary discomfort during the screening exam.
- Ask for the screening facility’s recall rate prior to booking the appointment and compare it to the national benchmark.
- Inquire if the radiologist employs batch reading to interpret mammograms.
- Supply the radiologist with previous mammogram images.
For more information: www.solismammo.com