Thurfjell E L, Lernevall K A, Taube A A
Department of Diagnostic Radiology, University Hospital, Uppsala, Sweden.
Radiology. 1994 Apr;191(1):241-4. doi: 10.1148/radiology.191.1.8134580.
To evaluate independent double reading in mammography screening and, specifically, the effect on breast cancer detection.
Mammographic studies of 11,343 women, aged 41-75 years, who participated in a population-based screening program were independently screened by two experienced radiologists. A retrospective analysis also was performed from notations made for patient recalls.
Including follow-up of recalled women, 131 surgical biopsies were performed, which resulted in 76 histologically proved breast cancers. Fifty-six cancerous lesions were detected by both screeners. One screener detected 14 cancerous lesions alone, and the other detected six alone. Of the cancerous lesions detected by only one screener, 85% were stage 0 or 1, compared with 59% of those detected by both screeners. Double reading detected 15% (95% confidence interval, +/- 7%) more cancer cases with an almost unchanged positive predictive value of 0.6.
Independent double reading does significantly increase sensitivity of mammography screening.
评估乳腺钼靶筛查中的独立双人阅片，特别是其对乳腺癌检测的影响。
对11343名年龄在41 - 75岁、参与基于人群的筛查项目的女性进行了乳腺钼靶检查，由两名经验丰富的放射科医生独立进行筛查。还根据患者召回记录进行了回顾性分析。
包括对召回女性的随访，共进行了131例手术活检，其中76例经组织学证实为乳腺癌。两名阅片者均检测到56个癌性病变。一名阅片者单独检测到14个癌性病变，另一名单独检测到6个。在仅由一名阅片者检测到的癌性病变中，85%为0期或1期，而两名阅片者均检测到的病变中这一比例为59%。双人阅片检测到的癌症病例增加了15%（95%置信区间，±7%），阳性预测值几乎不变，为0.6。
独立双人阅片确实显著提高了乳腺钼靶筛查的敏感性。
