title: Reproducibility of BI-RADS breast density measures among community radiologists: a prospective cohort study.
abstract: Using data from the Vermont Breast Cancer Surveillance System (VBCSS), we studied the reproducibility of Breast Imaging Reporting and Data System (BI-RADS) breast density among community radiologists interpreting mammograms in a cohort of 11,755 postmenopausal women. Radiologists interpreting two or more film-screen screening or bilateral diagnostic mammograms for the same woman within a 3- to 24-month period during 1996-2006 were eligible. We observed moderate-to-substantial overall intra-rater agreement for use of BI-RADS breast density in clinical practice, with an overall intra-radiologist percent agreement of 77.2% (95% confidence interval (CI), 74.5-79.5%), an overall simple kappa of 0.58 (95% CI, 0.55-0.61), and an overall weighted kappa of 0.70 (95% CI, 0.68-0.73). Agreement exhibited by individual radiologists varied widely, with intra-radiologist percent agreement ranging from 62.1% to 87.4% and simple kappa ranging from 0.19 to 0.69 across individual radiologists. Our findings underscore the need for additional evaluation of the BI-RADS breast density categorization system in clinical practice.
authors.affiliation: Canadian Partnership Against Cancer, Toronto, Ontario, Canada.
authors.forename: Mary C
authors.initials: MC
authors.lastname: Spayne
authors.forename: Charlotte C
authors.initials: CC
authors.lastname: Gard
authors.forename: Joan
authors.initials: J
authors.lastname: Skelly
authors.forename: Diana L
authors.initials: DL
authors.lastname: Miglioretti
authors.forename: Pamela M
authors.initials: PM
authors.lastname: Vacek
authors.forename: Berta M
authors.initials: BM
authors.lastname: Geller
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D010820:Physicians; D017698:Postmenopause; D011446:Prospective Studies; D011857:Radiographic Image Interpretation, Computer-Assisted; D011873:Radiology Information Systems / Q000592:standards*; D015203:Reproducibility of Results; D014707:Vermont; D000078329:Workforce