title: Re-attendance at biennial screening mammography following a repeated false positive recall.
abstract: We determined the re-attendance rate at screening mammography after a single or a repeated false positive recall and we assessed the effects of transition from screen-film mammography (SFM) to full-field digital mammography (FFDM) on screening outcome in women recalled twice for the same mammographic abnormality. The study population consisted of a consecutive series of 302,912 SFM and 90,288 FFDM screens. During a 2 years follow-up period (until the next biennial screen), we collected the breast imaging reports and biopsy results of all recalled women. Re-attendance at biennial screening mammography was 93.2 % (95 % CI 93.1-93.3 %) for women with a negative screen (i.e., no recall at screening mammography), 65.4 % (95 % CI 64.0-66.8 %) for women recalled once, 56.7 % (95 % CI 47.1-66.4 %) for women recalled twice but for different lesions and 44.3 % (95 % CI 31.4-57.1 %) for women recalled twice for the same lesion. FFDM recalls comprised a significantly larger proportion of women who had been recalled twice for the same lesion (1.9 % of recalls (52 women) at FFDM vs. 0.9 % of recalls (37 women) at SFM, P < 0.001) and the positive predictive value of these recalls (PPV) was significantly lower at FFDM (15.4 vs. 35.1 %, P = 0.03). At review, 20 of 52 women (39.5 %, all with benign outcome) would not have been recalled for a second time at FFDM if the previous hard copy SFM screen had been available for comparison. We conclude that a repeated false positive recall for the same lesion significantly lowered the probability of screening re-attendance. The first round of FFDM significantly increased the proportion of women recalled twice for the same lesion, with a significantly lower PPV of these lesions. Almost 40 % of repeatedly recalled women would not have been recalled the second time if the previous hard copy SFM screen had been available for comparison at the time of FFDM.
authors.affiliation: Department of Radiology, Catharina Hospital, PO Box 1350, 5602 ZA, Eindhoven, The Netherlands, elisabethgenevieve@hotmail.com.
authors.forename: Elisabeth G
authors.initials: EG
authors.lastname: Klompenhouwer
authors.forename: Lucien E M
authors.initials: LE
authors.lastname: Duijm
authors.forename: Adri C
authors.initials: AC
authors.lastname: Voogd
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: den Heeten
authors.forename: Luc J
authors.initials: LJ
authors.lastname: Strobbe
authors.forename: Marieke W
authors.initials: MW
authors.lastname: Louwman
authors.forename: Jan Willem
authors.initials: JW
authors.lastname: Coebergh
authors.forename: Dick
authors.initials: D
authors.lastname: Venderink
authors.forename: Mireille J M
authors.initials: MJ
authors.lastname: Broeders
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D008403:Mass Screening / Q000706:statistics & numerical data; D009426:Netherlands; D010358:Patient Participation / Q000706:statistics & numerical data*