De Faria Castro Fleury Eduardo, Ayres Veronica J
Radiology, MD duFLE Diagnósticos, São Paulo, BRA.
Mastology, Faculdade de Medicina do ABC, São Paulo, BRA.
Cureus. 2024 Oct 29;16(10):e72616. doi: 10.7759/cureus.72616. eCollection 2024 Oct.
This study aims to determine the impact of prior examination comparison in the final Breast Imaging and Reporting Data System (BI-RADS®) assessment in screening mammography. We compared the incidence of BI-RADS® categories 0, 1, 2, 3, 4, and 5 before and after comparing to the previous exam, with a focus on category 0. We also compared the radiologists' final classification according to their clinical practice experience.
This is a prospective observational study conducted from August 2020 to February 2021. Two radiologists independently interpreted 3,896 consecutive mammograms. The final BI-RADS® category was given for the mammography blinded to the previous examinations and after comparing the previous examination. We also compared the radiologists' final classification according to their clinical practice experience.
A total of 3,656 patients referred for breast mammography were evaluated, and 3,531 screening mammograms were included. The final BI-RADS® classification for mammograms blinded to previous examinations was as follows: 389 (11.02%), 3,017 (85.44%), 35 (0.99%), 87 (2.46%), and 3 (0.08%) for categories 0, 1, 2, 3, 4, and 5, respectively. After comparing the previous examinations, the results were as follows: 103 (2.92%), 3,311 (93.77%), 39 (1.10%), 75 (2.12%), and 3 (0.08%) for categories 0, 1, 2, 3, 4, and 5, respectively. Reader 1 read 1,439 mammograms, while reader 2 read 2,093 mammograms. When comparing the final category of each reader independently, reader 1 classified the mammograms as 91 (7.10%), 1,181 (92.19%), two (0.16%), and seven (0.55%) for blinded mammograms and 0, 1,261 (98.44%), six (0.47%), and 14 (1.09%) for mammograms after prior examination comparison for categories 0, 1 and 2, 3 and 4, respectively. Reader 2 classified the mammograms as 194 (9.27%), 1,181 (87.52%), 27 (1.29%), and 40 (1.91%) for blinded mammograms and one (0.05%), 2,044 (97.71%), 26 (1.24%), and 21 (1.00%) for mammograms after previous exams comparison for categories 0, 1 and 2, 3, and 4, respectively.
Comparing previous mammograms of participants in breast cancer screening programs may reduce the number of BI-RADS® category 0 final classifications by 73.8% and the number of positive findings in the final classification, especially for the less experienced readers.
本研究旨在确定在乳腺钼靶筛查中，先前检查对比对最终乳腺影像报告和数据系统（BI-RADS®）评估的影响。我们比较了与先前检查对比前后BI-RADS® 0、1、2、3、4和5类别的发生率，重点关注0类。我们还根据放射科医生的临床实践经验比较了他们的最终分类。
这是一项于2020年8月至2021年2月进行的前瞻性观察性研究。两名放射科医生独立解读了3896例连续的乳腺钼靶片。在对先前检查不知情的情况下以及在对比先前检查之后，分别给出乳腺钼靶的最终BI-RADS®类别。我们还根据放射科医生的临床实践经验比较了他们的最终分类。
总共评估了3656例接受乳腺钼靶检查的患者，纳入了3531例筛查乳腺钼靶片。对先前检查不知情的乳腺钼靶片的最终BI-RADS®分类如下：0类389例（11.02%），1类3017例（85.44%），2类35例（0.99%），3类87例（2.46%），4类3例（0.08%），5类3例（0.08%）。在对比先前检查之后，结果如下：0类103例（2.92%），1类3311例（93.77%），2类39例（1.10%），3类75例（2.12%），4类3例（0.08%），5类3例（0.08%）。读者1解读了1439例乳腺钼靶片，而读者2解读了2093例乳腺钼靶片。当分别独立比较每位读者的最终类别时，读者1将对先前检查不知情的乳腺钼靶片分类为0类91例（7.10%），1类1181例（92.19%），2类2例（0.16%），3类和4类7例（0.55%）；在对比先前检查之后，0类0例，1类1261例（98.44%），2类6例（0.47%），3类和4类14例（1.09%）。读者2将对先前检查不知情的乳腺钼靶片分类为0类194例（9.27%），1类1181例（87.52%），2类27例（1.29%），3类和4类40例（1.91%）；在对比先前检查之后，0类1例（0.05%），1类2044例（97.71%），2类26例（1.24%），3类和4类21例（1.00%）。
比较乳腺癌筛查项目参与者的先前乳腺钼靶片可能会使BI-RADS® 0类最终分类的数量减少73.8%，并减少最终分类中的阳性发现数量，尤其是对于经验较少的读者。
