Variability of Breast Density Classification Between US and UK Radiologists

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Title: Variability of Breast Density Classification Between US and UK Radiologists
Authors: Alomaim, Wijdan
O'Leary, Desiree
Ryan, John
Rainford, Louise
Evanoff, Michael
Foley, Shane J.
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Date: 5-Jan-2019
Online since: 2019-05-28T14:37:56Z
Abstract: Purpose: To assess whether subjective breast density categorization remains the most useful way to categorize mammographic breast density and whether variations exist across geographic regions with differing national legislation. Methods: Breast radiologists from two countries (UK, USA) were voluntarily recruited to review sets of anonymized mammographic images (n = 180) and additional repeated images (n = 70), totaling 250 images, to subjectively rate breast density according to the Breast Imaging Reporting and Data system (BI-RADS) categorization. Images were reviewed using standardized viewing conditions and Ziltron software. Inter-rater reliability was analyzed using the Kappa test. Results: The US radiologists (n = 25) judged fewer images as being “mostly fatty” than UK radiologists (n = 24), leading a greater number of images classified in the higher BI-RADS categories, particularly in BI-RADS 3. Overall agreement for all data sets was k = 0.654 indicating substantial agreement between the two cohorts. When the data were split into BI-RADS categories, the level of agreement varied from fair to substantial. Conclusion: Variations in how radiologists from the USA and UK classify breast density was established, especially when the data were divided into breast density categories. This variation supports the need for a reliable breast density assessment method to enhance the individualized supplemental screening pathways for dense breasts. The use of two-scale categorization method demonstrated improved agreement.
Type of material: Journal Article
Publisher: Elsevier
Journal: Journal of Medical Imaging and Radiation Sciences
Volume: 50
Issue: 1
Start page: 53
End page: 61
Keywords: Breast densityBI-RADSIntrarater variabilityMammography
DOI: 10.1016/j.jmir.2018.11.002
Language: en
Status of Item: Peer reviewed
Appears in Collections:Medicine Research Collection

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