Correlation between breast parenchymal patterns and mammographers' certainty of diagnosis.

The density of breast tissue on a mammogram may affect radiologists' diagnostic decisions. To evaluate possible correlations among breast parenchymal pattern and diagnostic confidence, six radiologists classified 655 mammograms as N1, P1, P2, and DY, according to Wolfe's criteria. Evaluation of radiologists' confidence interpreting the mammograms (1 = absolutely certain, 2 = fairly certain, 3 = uncertain), shows a significant correlation between decreasing diagnostic certainty and increasing complexity of the mammographic breast parenchymal pattern. That readers are less confident in their interpretation of P2 and DY breast parenchymal patterns has implications for the operation of breast cancer screening programs.