title: Trends in recall, biopsy, and positive biopsy rates for screening mammography in an academic practice.
abstract: OBJECTIVE
  To retrospectively evaluate whether recall, biopsy, and positive biopsy rates for a group of radiologists who met requirements of Mammography Quality Standards Act of 1992 (MQSA) demonstrated any change over time during a 27-month period (nine consecutive calendar quarters).
  
  
  METHODS
  Institutional review board approved study protocol, and informed consent was waived. All screening mammograms that had been interpreted by MQSA-qualified radiologists between January 1, 2001, and March 31, 2003, were reviewed. Group recall rates, biopsy rates, and detected cancer rates for nine calendar quarters were computed and attributed to performance date of original screening mammogram. Type of biopsy performed was classified as follows: stereotactic vacuum-assisted biopsy, ultrasonography (US)-guided core biopsy, US-guided fine-needle aspiration biopsy, surgical excision, and multiple biopsies. chi(2) Test for trend (two sided) and linear regression were used to assess trends over time for recall and biopsy rates, biopsy rates according to type of biopsy performed, and percentage of biopsy results positive for cancer.
  
  
  RESULTS
  Group recall rate did not show a statistically significant trend during period studied (P = .59). Biopsy rates increased significantly from 13.02 to 20.12 per 1000 screening examinations (P < .001). A corresponding substantial decrease was seen in percentage of biopsies in which malignancy was found, although this trend was not statistically significant (P = .24). A significant increase (from 4.72 to 9.88 per 1000 screening examinations) was found in rate of stereotactic vacuum-assisted 11-gauge core biopsies performed (P < .001).
  
  
  CONCLUSIONS
  Observed increase in biopsy rates reinforces the need to carefully select patients for biopsy to achieve efficient, efficacious, and cost-effective programs for early detection of breast cancers.
authors.affiliation: Department of Radiology, University of Pittsburgh and Magee-Womens Hospital of the University of Pittsburgh Medical Center, 300 Halket Street, Imaging Research, Suite 4200, Pittsburgh, PA 15213-3180, USA. gurd@upmc.edu
authors.forename: David
authors.initials: D
authors.lastname: Gur
authors.forename: Luisa P
authors.initials: LP
authors.lastname: Wallace
authors.forename: Amy H
authors.initials: AH
authors.lastname: Klym
authors.forename: Lara A
authors.initials: LA
authors.lastname: Hardesty
authors.forename: Gordon S
authors.initials: GS
authors.lastname: Abrams
authors.forename: Ratan
authors.initials: R
authors.lastname: Shah
authors.forename: Jules H
authors.initials: JH
authors.lastname: Sumkin
mesh_terms: D001706:Biopsy / Q000145:classification / Q000191:economics / Q000639:trends*; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D003362:Cost-Benefit Analysis / Q000639:trends; D003936:Diagnosis, Computer-Assisted / Q000191:economics / Q000639:trends; D005260:Female; D005544:Forecasting; D006301:Health Services Needs and Demand / Q000191:economics / Q000639:trends; D006801:Humans; D008327:Mammography / Q000191:economics / Q000639:trends*; D008403:Mass Screening / Q000191:economics / Q000639:trends*; D011785:Quality Assurance, Health Care / Q000191:economics / Q000592:standards; D019984:Quality Indicators, Health Care / Q000639:trends; D012044:Regression Analysis; D012189:Retrospective Studies; D014481:United States