Factors Impacting False Positive Recall in Screening Mammography

Evan L. Honig, Lisa Mullen, Tali Amir, Matthew D. Alvin, Mary K. Jones, Emily Ambinder, Eniola T. Falomo, Susan Harvey

Research output: Contribution to journalArticle

Abstract

Rationale and Objectives: Our objective was to identify factors impacting false positive recalls in screening mammography. Materials and Methods: We retrospectively reviewed our screening mammography database from August 31, 2015 to September 30, 2016, including full field digital mammograms (FFDM) and digital breast tomosynthesis (DBT) mammograms. False positive (FP) exams were defined as Breast Imaging-Reporting and Data System (BI-RADS) 1 or 2 assessments at diagnostic imaging with 1 year cancer-free follow-up, Breast Imaging-Reporting and Data System 3 assessment at diagnostic imaging with 2 years cancer free follow-up, or biopsy with benign pathology. True positives were defined as malignant pathology on biopsy or surgical excision. We evaluated the association of FP recalls with multiple patient-level factors and imaging features. Results: A total of 22,055 screening mammograms were performed, and 1887 patients were recalled (recall rate 8.6%). Recall rate was lower for DBT than full field digital mammograms (8.0% vs 10.6%, p < 0.001). FP results were lower if prior mammograms were available (90.8% vs 95.8%, p = 0.02), and if there was a previous benign breast biopsy (87.6% vs 92.9%, p = 0.01). Mean age for the FP group was lower than the true positive group (56.1 vs 62.9 years, p < 0.001). There were no significant differences in FP recalls based on history of high-risk lesions, family history of breast or ovarian cancer, hormone use, breast density, race, or body mass index. Conclusion: FP recalls were significantly less likely with DBT, in older women, in patients with prior mammograms available for comparison, and in patients with histories of benign breast biopsy. This study supports the importance of using DBT in the screening setting and obtaining prior mammograms for comparison.

Original languageEnglish (US)
JournalAcademic Radiology
DOIs
StatePublished - Jan 1 2019

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Mammography
Breast
Biopsy
Diagnostic Imaging
Information Systems
Pathology
Ovarian Neoplasms
Neoplasms
Body Mass Index
Databases
Hormones
Breast Neoplasms

Keywords

  • Breast cancer
  • Digital breast tomosynthesis
  • Mammographic screening
  • Recall

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Factors Impacting False Positive Recall in Screening Mammography. / Honig, Evan L.; Mullen, Lisa; Amir, Tali; Alvin, Matthew D.; Jones, Mary K.; Ambinder, Emily; Falomo, Eniola T.; Harvey, Susan.

In: Academic Radiology, 01.01.2019.

Research output: Contribution to journalArticle

Honig, Evan L. ; Mullen, Lisa ; Amir, Tali ; Alvin, Matthew D. ; Jones, Mary K. ; Ambinder, Emily ; Falomo, Eniola T. ; Harvey, Susan. / Factors Impacting False Positive Recall in Screening Mammography. In: Academic Radiology. 2019.
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abstract = "Rationale and Objectives: Our objective was to identify factors impacting false positive recalls in screening mammography. Materials and Methods: We retrospectively reviewed our screening mammography database from August 31, 2015 to September 30, 2016, including full field digital mammograms (FFDM) and digital breast tomosynthesis (DBT) mammograms. False positive (FP) exams were defined as Breast Imaging-Reporting and Data System (BI-RADS) 1 or 2 assessments at diagnostic imaging with 1 year cancer-free follow-up, Breast Imaging-Reporting and Data System 3 assessment at diagnostic imaging with 2 years cancer free follow-up, or biopsy with benign pathology. True positives were defined as malignant pathology on biopsy or surgical excision. We evaluated the association of FP recalls with multiple patient-level factors and imaging features. Results: A total of 22,055 screening mammograms were performed, and 1887 patients were recalled (recall rate 8.6{\%}). Recall rate was lower for DBT than full field digital mammograms (8.0{\%} vs 10.6{\%}, p < 0.001). FP results were lower if prior mammograms were available (90.8{\%} vs 95.8{\%}, p = 0.02), and if there was a previous benign breast biopsy (87.6{\%} vs 92.9{\%}, p = 0.01). Mean age for the FP group was lower than the true positive group (56.1 vs 62.9 years, p < 0.001). There were no significant differences in FP recalls based on history of high-risk lesions, family history of breast or ovarian cancer, hormone use, breast density, race, or body mass index. Conclusion: FP recalls were significantly less likely with DBT, in older women, in patients with prior mammograms available for comparison, and in patients with histories of benign breast biopsy. This study supports the importance of using DBT in the screening setting and obtaining prior mammograms for comparison.",
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