Mammography: Screening Recall Rate and Practice Site

 Ana P Lourenco MD  Assistant Professor of Diagnostic Imaging Alpert Medical School of Brown Interview with: Ana P Lourenco MD

Assistant Professor of Diagnostic Imaging
Alpert Medical School of Brown University What are the main findings of the study?

Dr. Lourenco: Our study found a significantly higher recall rate for screening mammography at a tertiary referral hospital compared with a community private practice.  We compared recall rates for 5 fellowship trained radiologists reading at both sites, and all five radiologists had higher recall rates at the hospital site.  When we analyzed patient factors in an effort to explain why this might be, we found that the average age of patients in the hospital was younger (which is known to be associated with higher recall rate) and that more patients at the hospital had a personal history of prior breast biopsy or surgery (also known to be associated with higher recall rate). :Were any of the findings unexpected?

Dr. Lourenco: We had expected that the recall rate might be higher at the hospital, but were surprised to find that this was true for all 5 radiologists working at both sites. What should clinicians and patients take away from your report?

Dr. Lourenco: I think it is important to realize that screening mammography recall rate can be influenced by many factors, some of which are out of the radiologist’s control.  Further, it is important to acknowledge that recall rate is just one of the data points tracked in mammography, and that other data such as cancer detection rate and biopsy positive predictive values may provide more insight into the the true quality of a breast center. What recommendations do you have for future research as a result of this study?

Dr. Lourenco: I think it will be important to involve physicians in creating quality metrics as we move forward with healthcare reform and struggle to find measurable quality indicators in each subspecialty.  Our study, for example, shows that recall rate can vary substantially by site and raises questions about the utility of this commonly tracked and readily available data point as a quality marker.  Cancer detection rate may be a much more accurate reflection of quality, but requires more intensive data analysis and tracking to assess it accurately.


Screening Mammography Recall Rate: Does Practice Site Matter?

Rothschild J, Lourenco AP, Mainiero MB.

Department of Diagnostic Imaging, Alpert Medical School of Brown University, Rhode Island Hospital, 593 Eddy St, 3rd Floor Main Bldg, Providence, RI 02903.

Radiology. 2013 Jul 24. [Epub ahead of print]


Last Updated on August 9, 2013 by Marie Benz MD FAAD