title: Does Reader Performance with Digital Breast Tomosynthesis Vary according to Experience with Two-dimensional Mammography?
abstract: Purpose To assess whether individual reader performance with digital breast tomosynthesis (DBT) and two-dimensional (2D) mammography varies with number of years of experience or volume of 2D mammograms read. Materials and Methods After written informed consent was obtained, 8869 women (age range, 29-85 years; mean age, 56 years) were recruited into the TOMMY trial (A Comparison of Tomosynthesis with Digital Mammography in the UK National Health Service Breast Screening Program), an ethically approved, multicenter, multireader, retrospective reading study, between July 2011 and March 2013. Each case was read prospectively for clinical assessment and to establish ground truth. A retrospective reading data set of 7060 cases was created and randomly allocated for independent blinded review of (a) 2D mammograms, (b) DBT images and 2D mammograms, and (c) synthetic 2D mammograms and DBT images, without access to previous examinations. Readers (19 radiologists, three advanced practitioner radiographers, and two breast clinicians) who had 3-25 (median, 10) years of experience in the U.K. National Health Service Breast Screening Program and read 5000-13 000 (median, 8000) cases per annum were included in this study. Specificity was analyzed according to reader type and years and volume of experience, and then both specificity and sensitivity were analyzed by matched inference. The median duration of experience (10 years) was used as the cutoff point for comparison of reader performance. Results Specificity improved with the addition of DBT for all readers. This was significant for all staff groups (56% vs 68% and 49% vs 67% [P < .0001] for radiologists and advanced practitioner radiographers, respectively; 46% vs 55% [P = .02] for breast clinicians). Sensitivity was improved for 19 of 24 (79%) readers and was significantly higher for those with less than 10 years of experience (91% vs 86%; P = .03) and those with total mammographic experience of fewer than 80 000 cases (88% vs 86%; P = .03). Conclusion The addition of DBT to conventional 2D screening mammography improved specificity for all readers, but the gain in sensitivity was greater for readers with less than 10 years of experience.
authors.affiliation: From the Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, England (L.T., F.J.G.); Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester, England (S.M.A.); Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, England (A.D., S.W.D.); West of Scotland Breast Screening Service, Glasgow, Scotland (A.S., J.L., H.M.D., L.M.); Department of Radiology, King's College Hospital, London, England (J.M., J.G., R.R.); Department of Radiology, University Hospital of South Manchester, Manchester, England (S.B., U.B., Y.Y.L., E.H.); North East Scotland Breast Screening Centre, Aberdeen, Scotland (H.K., G.L.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (H.P.); Jarvis Breast Centre, Guildford, England (P.S., K.S., C.K.); Department of Clinical Radiology, Aberdeen Royal Infirmary, Aberdeen, Scotland (T.J.G.); and Department of Radiology, St Bartholomew's Hospital, London, England (T.S.).
authors.forename: Lorraine
authors.initials: L
authors.lastname: Tucker
authors.affiliation: From the Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, England (L.T., F.J.G.); Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester, England (S.M.A.); Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, England (A.D., S.W.D.); West of Scotland Breast Screening Service, Glasgow, Scotland (A.S., J.L., H.M.D., L.M.); Department of Radiology, King's College Hospital, London, England (J.M., J.G., R.R.); Department of Radiology, University Hospital of South Manchester, Manchester, England (S.B., U.B., Y.Y.L., E.H.); North East Scotland Breast Screening Centre, Aberdeen, Scotland (H.K., G.L.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (H.P.); Jarvis Breast Centre, Guildford, England (P.S., K.S., C.K.); Department of Clinical Radiology, Aberdeen Royal Infirmary, Aberdeen, Scotland (T.J.G.); and Department of Radiology, St Bartholomew's Hospital, London, England (T.S.).
authors.forename: Fiona J
authors.initials: FJ
authors.lastname: Gilbert
authors.affiliation: From the Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, England (L.T., F.J.G.); Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester, England (S.M.A.); Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, England (A.D., S.W.D.); West of Scotland Breast Screening Service, Glasgow, Scotland (A.S., J.L., H.M.D., L.M.); Department of Radiology, King's College Hospital, London, England (J.M., J.G., R.R.); Department of Radiology, University Hospital of South Manchester, Manchester, England (S.B., U.B., Y.Y.L., E.H.); North East Scotland Breast Screening Centre, Aberdeen, Scotland (H.K., G.L.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (H.P.); Jarvis Breast Centre, Guildford, England (P.S., K.S., C.K.); Department of Clinical Radiology, Aberdeen Royal Infirmary, Aberdeen, Scotland (T.J.G.); and Department of Radiology, St Bartholomew's Hospital, London, England (T.S.).
authors.forename: Susan M
authors.initials: SM
authors.lastname: Astley
authors.affiliation: From the Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, England (L.T., F.J.G.); Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester, England (S.M.A.); Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, England (A.D., S.W.D.); West of Scotland Breast Screening Service, Glasgow, Scotland (A.S., J.L., H.M.D., L.M.); Department of Radiology, King's College Hospital, London, England (J.M., J.G., R.R.); Department of Radiology, University Hospital of South Manchester, Manchester, England (S.B., U.B., Y.Y.L., E.H.); North East Scotland Breast Screening Centre, Aberdeen, Scotland (H.K., G.L.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (H.P.); Jarvis Breast Centre, Guildford, England (P.S., K.S., C.K.); Department of Clinical Radiology, Aberdeen Royal Infirmary, Aberdeen, Scotland (T.J.G.); and Department of Radiology, St Bartholomew's Hospital, London, England (T.S.).
authors.forename: Amanda
authors.initials: A
authors.lastname: Dibden
authors.affiliation: From the Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, England (L.T., F.J.G.); Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester, England (S.M.A.); Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, England (A.D., S.W.D.); West of Scotland Breast Screening Service, Glasgow, Scotland (A.S., J.L., H.M.D., L.M.); Department of Radiology, King's College Hospital, London, England (J.M., J.G., R.R.); Department of Radiology, University Hospital of South Manchester, Manchester, England (S.B., U.B., Y.Y.L., E.H.); North East Scotland Breast Screening Centre, Aberdeen, Scotland (H.K., G.L.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (H.P.); Jarvis Breast Centre, Guildford, England (P.S., K.S., C.K.); Department of Clinical Radiology, Aberdeen Royal Infirmary, Aberdeen, Scotland (T.J.G.); and Department of Radiology, St Bartholomew's Hospital, London, England (T.S.).
authors.forename: Archana
authors.initials: A
authors.lastname: Seth
authors.affiliation: From the Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, England (L.T., F.J.G.); Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester, England (S.M.A.); Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, England (A.D., S.W.D.); West of Scotland Breast Screening Service, Glasgow, Scotland (A.S., J.L., H.M.D., L.M.); Department of Radiology, King's College Hospital, London, England (J.M., J.G., R.R.); Department of Radiology, University Hospital of South Manchester, Manchester, England (S.B., U.B., Y.Y.L., E.H.); North East Scotland Breast Screening Centre, Aberdeen, Scotland (H.K., G.L.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (H.P.); Jarvis Breast Centre, Guildford, England (P.S., K.S., C.K.); Department of Clinical Radiology, Aberdeen Royal Infirmary, Aberdeen, Scotland (T.J.G.); and Department of Radiology, St Bartholomew's Hospital, London, England (T.S.).
authors.forename: Juliet
authors.initials: J
authors.lastname: Morel
authors.affiliation: From the Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, England (L.T., F.J.G.); Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester, England (S.M.A.); Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, England (A.D., S.W.D.); West of Scotland Breast Screening Service, Glasgow, Scotland (A.S., J.L., H.M.D., L.M.); Department of Radiology, King's College Hospital, London, England (J.M., J.G., R.R.); Department of Radiology, University Hospital of South Manchester, Manchester, England (S.B., U.B., Y.Y.L., E.H.); North East Scotland Breast Screening Centre, Aberdeen, Scotland (H.K., G.L.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (H.P.); Jarvis Breast Centre, Guildford, England (P.S., K.S., C.K.); Department of Clinical Radiology, Aberdeen Royal Infirmary, Aberdeen, Scotland (T.J.G.); and Department of Radiology, St Bartholomew's Hospital, London, England (T.S.).
authors.forename: Sara
authors.initials: S
authors.lastname: Bundred
authors.affiliation: From the Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, England (L.T., F.J.G.); Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester, England (S.M.A.); Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, England (A.D., S.W.D.); West of Scotland Breast Screening Service, Glasgow, Scotland (A.S., J.L., H.M.D., L.M.); Department of Radiology, King's College Hospital, London, England (J.M., J.G., R.R.); Department of Radiology, University Hospital of South Manchester, Manchester, England (S.B., U.B., Y.Y.L., E.H.); North East Scotland Breast Screening Centre, Aberdeen, Scotland (H.K., G.L.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (H.P.); Jarvis Breast Centre, Guildford, England (P.S., K.S., C.K.); Department of Clinical Radiology, Aberdeen Royal Infirmary, Aberdeen, Scotland (T.J.G.); and Department of Radiology, St Bartholomew's Hospital, London, England (T.S.).
authors.forename: Janet
authors.initials: J
authors.lastname: Litherland
authors.affiliation: From the Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, England (L.T., F.J.G.); Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester, England (S.M.A.); Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, England (A.D., S.W.D.); West of Scotland Breast Screening Service, Glasgow, Scotland (A.S., J.L., H.M.D., L.M.); Department of Radiology, King's College Hospital, London, England (J.M., J.G., R.R.); Department of Radiology, University Hospital of South Manchester, Manchester, England (S.B., U.B., Y.Y.L., E.H.); North East Scotland Breast Screening Centre, Aberdeen, Scotland (H.K., G.L.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (H.P.); Jarvis Breast Centre, Guildford, England (P.S., K.S., C.K.); Department of Clinical Radiology, Aberdeen Royal Infirmary, Aberdeen, Scotland (T.J.G.); and Department of Radiology, St Bartholomew's Hospital, London, England (T.S.).
authors.forename: Herman
authors.initials: H
authors.lastname: Klassen
authors.affiliation: From the Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, England (L.T., F.J.G.); Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester, England (S.M.A.); Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, England (A.D., S.W.D.); West of Scotland Breast Screening Service, Glasgow, Scotland (A.S., J.L., H.M.D., L.M.); Department of Radiology, King's College Hospital, London, England (J.M., J.G., R.R.); Department of Radiology, University Hospital of South Manchester, Manchester, England (S.B., U.B., Y.Y.L., E.H.); North East Scotland Breast Screening Centre, Aberdeen, Scotland (H.K., G.L.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (H.P.); Jarvis Breast Centre, Guildford, England (P.S., K.S., C.K.); Department of Clinical Radiology, Aberdeen Royal Infirmary, Aberdeen, Scotland (T.J.G.); and Department of Radiology, St Bartholomew's Hospital, London, England (T.S.).
authors.forename: Gerald
authors.initials: G
authors.lastname: Lip
authors.affiliation: From the Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, England (L.T., F.J.G.); Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester, England (S.M.A.); Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, England (A.D., S.W.D.); West of Scotland Breast Screening Service, Glasgow, Scotland (A.S., J.L., H.M.D., L.M.); Department of Radiology, King's College Hospital, London, England (J.M., J.G., R.R.); Department of Radiology, University Hospital of South Manchester, Manchester, England (S.B., U.B., Y.Y.L., E.H.); North East Scotland Breast Screening Centre, Aberdeen, Scotland (H.K., G.L.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (H.P.); Jarvis Breast Centre, Guildford, England (P.S., K.S., C.K.); Department of Clinical Radiology, Aberdeen Royal Infirmary, Aberdeen, Scotland (T.J.G.); and Department of Radiology, St Bartholomew's Hospital, London, England (T.S.).
authors.forename: Hema
authors.initials: H
authors.lastname: Purushothaman
authors.affiliation: From the Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, England (L.T., F.J.G.); Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester, England (S.M.A.); Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, England (A.D., S.W.D.); West of Scotland Breast Screening Service, Glasgow, Scotland (A.S., J.L., H.M.D., L.M.); Department of Radiology, King's College Hospital, London, England (J.M., J.G., R.R.); Department of Radiology, University Hospital of South Manchester, Manchester, England (S.B., U.B., Y.Y.L., E.H.); North East Scotland Breast Screening Centre, Aberdeen, Scotland (H.K., G.L.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (H.P.); Jarvis Breast Centre, Guildford, England (P.S., K.S., C.K.); Department of Clinical Radiology, Aberdeen Royal Infirmary, Aberdeen, Scotland (T.J.G.); and Department of Radiology, St Bartholomew's Hospital, London, England (T.S.).
authors.forename: Hilary M
authors.initials: HM
authors.lastname: Dobson
authors.affiliation: From the Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, England (L.T., F.J.G.); Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester, England (S.M.A.); Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, England (A.D., S.W.D.); West of Scotland Breast Screening Service, Glasgow, Scotland (A.S., J.L., H.M.D., L.M.); Department of Radiology, King's College Hospital, London, England (J.M., J.G., R.R.); Department of Radiology, University Hospital of South Manchester, Manchester, England (S.B., U.B., Y.Y.L., E.H.); North East Scotland Breast Screening Centre, Aberdeen, Scotland (H.K., G.L.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (H.P.); Jarvis Breast Centre, Guildford, England (P.S., K.S., C.K.); Department of Clinical Radiology, Aberdeen Royal Infirmary, Aberdeen, Scotland (T.J.G.); and Department of Radiology, St Bartholomew's Hospital, London, England (T.S.).
authors.forename: Linda
authors.initials: L
authors.lastname: McClure
authors.affiliation: From the Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, England (L.T., F.J.G.); Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester, England (S.M.A.); Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, England (A.D., S.W.D.); West of Scotland Breast Screening Service, Glasgow, Scotland (A.S., J.L., H.M.D., L.M.); Department of Radiology, King's College Hospital, London, England (J.M., J.G., R.R.); Department of Radiology, University Hospital of South Manchester, Manchester, England (S.B., U.B., Y.Y.L., E.H.); North East Scotland Breast Screening Centre, Aberdeen, Scotland (H.K., G.L.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (H.P.); Jarvis Breast Centre, Guildford, England (P.S., K.S., C.K.); Department of Clinical Radiology, Aberdeen Royal Infirmary, Aberdeen, Scotland (T.J.G.); and Department of Radiology, St Bartholomew's Hospital, London, England (T.S.).
authors.forename: Philippa
authors.initials: P
authors.lastname: Skippage
authors.affiliation: From the Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, England (L.T., F.J.G.); Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester, England (S.M.A.); Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, England (A.D., S.W.D.); West of Scotland Breast Screening Service, Glasgow, Scotland (A.S., J.L., H.M.D., L.M.); Department of Radiology, King's College Hospital, London, England (J.M., J.G., R.R.); Department of Radiology, University Hospital of South Manchester, Manchester, England (S.B., U.B., Y.Y.L., E.H.); North East Scotland Breast Screening Centre, Aberdeen, Scotland (H.K., G.L.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (H.P.); Jarvis Breast Centre, Guildford, England (P.S., K.S., C.K.); Department of Clinical Radiology, Aberdeen Royal Infirmary, Aberdeen, Scotland (T.J.G.); and Department of Radiology, St Bartholomew's Hospital, London, England (T.S.).
authors.forename: Katherine
authors.initials: K
authors.lastname: Stoner
authors.affiliation: From the Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, England (L.T., F.J.G.); Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester, England (S.M.A.); Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, England (A.D., S.W.D.); West of Scotland Breast Screening Service, Glasgow, Scotland (A.S., J.L., H.M.D., L.M.); Department of Radiology, King's College Hospital, London, England (J.M., J.G., R.R.); Department of Radiology, University Hospital of South Manchester, Manchester, England (S.B., U.B., Y.Y.L., E.H.); North East Scotland Breast Screening Centre, Aberdeen, Scotland (H.K., G.L.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (H.P.); Jarvis Breast Centre, Guildford, England (P.S., K.S., C.K.); Department of Clinical Radiology, Aberdeen Royal Infirmary, Aberdeen, Scotland (T.J.G.); and Department of Radiology, St Bartholomew's Hospital, London, England (T.S.).
authors.forename: Caroline
authors.initials: C
authors.lastname: Kissin
authors.affiliation: From the Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, England (L.T., F.J.G.); Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester, England (S.M.A.); Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, England (A.D., S.W.D.); West of Scotland Breast Screening Service, Glasgow, Scotland (A.S., J.L., H.M.D., L.M.); Department of Radiology, King's College Hospital, London, England (J.M., J.G., R.R.); Department of Radiology, University Hospital of South Manchester, Manchester, England (S.B., U.B., Y.Y.L., E.H.); North East Scotland Breast Screening Centre, Aberdeen, Scotland (H.K., G.L.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (H.P.); Jarvis Breast Centre, Guildford, England (P.S., K.S., C.K.); Department of Clinical Radiology, Aberdeen Royal Infirmary, Aberdeen, Scotland (T.J.G.); and Department of Radiology, St Bartholomew's Hospital, London, England (T.S.).
authors.forename: Ursula
authors.initials: U
authors.lastname: Beetles
authors.affiliation: From the Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, England (L.T., F.J.G.); Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester, England (S.M.A.); Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, England (A.D., S.W.D.); West of Scotland Breast Screening Service, Glasgow, Scotland (A.S., J.L., H.M.D., L.M.); Department of Radiology, King's College Hospital, London, England (J.M., J.G., R.R.); Department of Radiology, University Hospital of South Manchester, Manchester, England (S.B., U.B., Y.Y.L., E.H.); North East Scotland Breast Screening Centre, Aberdeen, Scotland (H.K., G.L.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (H.P.); Jarvis Breast Centre, Guildford, England (P.S., K.S., C.K.); Department of Clinical Radiology, Aberdeen Royal Infirmary, Aberdeen, Scotland (T.J.G.); and Department of Radiology, St Bartholomew's Hospital, London, England (T.S.).
authors.forename: Yit Yoong
authors.initials: YY
authors.lastname: Lim
authors.affiliation: From the Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, England (L.T., F.J.G.); Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester, England (S.M.A.); Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, England (A.D., S.W.D.); West of Scotland Breast Screening Service, Glasgow, Scotland (A.S., J.L., H.M.D., L.M.); Department of Radiology, King's College Hospital, London, England (J.M., J.G., R.R.); Department of Radiology, University Hospital of South Manchester, Manchester, England (S.B., U.B., Y.Y.L., E.H.); North East Scotland Breast Screening Centre, Aberdeen, Scotland (H.K., G.L.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (H.P.); Jarvis Breast Centre, Guildford, England (P.S., K.S., C.K.); Department of Clinical Radiology, Aberdeen Royal Infirmary, Aberdeen, Scotland (T.J.G.); and Department of Radiology, St Bartholomew's Hospital, London, England (T.S.).
authors.forename: Emma
authors.initials: E
authors.lastname: Hurley
authors.affiliation: From the Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, England (L.T., F.J.G.); Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester, England (S.M.A.); Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, England (A.D., S.W.D.); West of Scotland Breast Screening Service, Glasgow, Scotland (A.S., J.L., H.M.D., L.M.); Department of Radiology, King's College Hospital, London, England (J.M., J.G., R.R.); Department of Radiology, University Hospital of South Manchester, Manchester, England (S.B., U.B., Y.Y.L., E.H.); North East Scotland Breast Screening Centre, Aberdeen, Scotland (H.K., G.L.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (H.P.); Jarvis Breast Centre, Guildford, England (P.S., K.S., C.K.); Department of Clinical Radiology, Aberdeen Royal Infirmary, Aberdeen, Scotland (T.J.G.); and Department of Radiology, St Bartholomew's Hospital, London, England (T.S.).
authors.forename: Jane
authors.initials: J
authors.lastname: Goligher
authors.affiliation: From the Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, England (L.T., F.J.G.); Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester, England (S.M.A.); Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, England (A.D., S.W.D.); West of Scotland Breast Screening Service, Glasgow, Scotland (A.S., J.L., H.M.D., L.M.); Department of Radiology, King's College Hospital, London, England (J.M., J.G., R.R.); Department of Radiology, University Hospital of South Manchester, Manchester, England (S.B., U.B., Y.Y.L., E.H.); North East Scotland Breast Screening Centre, Aberdeen, Scotland (H.K., G.L.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (H.P.); Jarvis Breast Centre, Guildford, England (P.S., K.S., C.K.); Department of Clinical Radiology, Aberdeen Royal Infirmary, Aberdeen, Scotland (T.J.G.); and Department of Radiology, St Bartholomew's Hospital, London, England (T.S.).
authors.forename: Rumana
authors.initials: R
authors.lastname: Rahim
authors.affiliation: From the Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, England (L.T., F.J.G.); Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester, England (S.M.A.); Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, England (A.D., S.W.D.); West of Scotland Breast Screening Service, Glasgow, Scotland (A.S., J.L., H.M.D., L.M.); Department of Radiology, King's College Hospital, London, England (J.M., J.G., R.R.); Department of Radiology, University Hospital of South Manchester, Manchester, England (S.B., U.B., Y.Y.L., E.H.); North East Scotland Breast Screening Centre, Aberdeen, Scotland (H.K., G.L.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (H.P.); Jarvis Breast Centre, Guildford, England (P.S., K.S., C.K.); Department of Clinical Radiology, Aberdeen Royal Infirmary, Aberdeen, Scotland (T.J.G.); and Department of Radiology, St Bartholomew's Hospital, London, England (T.S.).
authors.forename: Tanja J
authors.initials: TJ
authors.lastname: Gagliardi
authors.affiliation: From the Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, England (L.T., F.J.G.); Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester, England (S.M.A.); Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, England (A.D., S.W.D.); West of Scotland Breast Screening Service, Glasgow, Scotland (A.S., J.L., H.M.D., L.M.); Department of Radiology, King's College Hospital, London, England (J.M., J.G., R.R.); Department of Radiology, University Hospital of South Manchester, Manchester, England (S.B., U.B., Y.Y.L., E.H.); North East Scotland Breast Screening Centre, Aberdeen, Scotland (H.K., G.L.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (H.P.); Jarvis Breast Centre, Guildford, England (P.S., K.S., C.K.); Department of Clinical Radiology, Aberdeen Royal Infirmary, Aberdeen, Scotland (T.J.G.); and Department of Radiology, St Bartholomew's Hospital, London, England (T.S.).
authors.forename: Tamara
authors.initials: T
authors.lastname: Suaris
authors.affiliation: From the Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, England (L.T., F.J.G.); Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester, England (S.M.A.); Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, England (A.D., S.W.D.); West of Scotland Breast Screening Service, Glasgow, Scotland (A.S., J.L., H.M.D., L.M.); Department of Radiology, King's College Hospital, London, England (J.M., J.G., R.R.); Department of Radiology, University Hospital of South Manchester, Manchester, England (S.B., U.B., Y.Y.L., E.H.); North East Scotland Breast Screening Centre, Aberdeen, Scotland (H.K., G.L.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (H.P.); Jarvis Breast Centre, Guildford, England (P.S., K.S., C.K.); Department of Clinical Radiology, Aberdeen Royal Infirmary, Aberdeen, Scotland (T.J.G.); and Department of Radiology, St Bartholomew's Hospital, London, England (T.S.).
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Duffy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology; D002983:Clinical Competence / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D015588:Observer Variation; D000072177:Radiologists / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D006113:United Kingdom / Q000453:epidemiology