Performance of clinical mammography: a nationwide study from Denmark

Research output: Contribution to journalJournal articlepeer-review

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Performance of clinical mammography: a nationwide study from Denmark. / Jensen, Allan; Vejborg, Ilse; Severinsen, Niels; Nielsen, Susanne; Rank, Fritz; Mikkelsen, Gerd Just; Hilden, Jørgen; Vistisen, Dorte; Dyreborg, Uffe; Lynge, Elsebeth.

In: International Journal of Cancer, Vol. 119, No. 1, 2006, p. 183-91.

Research output: Contribution to journalJournal articlepeer-review

Harvard

Jensen, A, Vejborg, I, Severinsen, N, Nielsen, S, Rank, F, Mikkelsen, GJ, Hilden, J, Vistisen, D, Dyreborg, U & Lynge, E 2006, 'Performance of clinical mammography: a nationwide study from Denmark', International Journal of Cancer, vol. 119, no. 1, pp. 183-91. https://doi.org/10.1002/ijc.21811

APA

Jensen, A., Vejborg, I., Severinsen, N., Nielsen, S., Rank, F., Mikkelsen, G. J., Hilden, J., Vistisen, D., Dyreborg, U., & Lynge, E. (2006). Performance of clinical mammography: a nationwide study from Denmark. International Journal of Cancer, 119(1), 183-91. https://doi.org/10.1002/ijc.21811

Vancouver

Jensen A, Vejborg I, Severinsen N, Nielsen S, Rank F, Mikkelsen GJ et al. Performance of clinical mammography: a nationwide study from Denmark. International Journal of Cancer. 2006;119(1):183-91. https://doi.org/10.1002/ijc.21811

Author

Jensen, Allan ; Vejborg, Ilse ; Severinsen, Niels ; Nielsen, Susanne ; Rank, Fritz ; Mikkelsen, Gerd Just ; Hilden, Jørgen ; Vistisen, Dorte ; Dyreborg, Uffe ; Lynge, Elsebeth. / Performance of clinical mammography: a nationwide study from Denmark. In: International Journal of Cancer. 2006 ; Vol. 119, No. 1. pp. 183-91.

Bibtex

@article{9d7e1f109d4b11debc73000ea68e967b,
title = "Performance of clinical mammography: a nationwide study from Denmark",
abstract = "Clinical mammography is the key tool for breast cancer diagnosis, but little is known about the impact of the organisational set-up on the performance. We evaluated whether organisational factors influence the performance of clinical mammography. Clinical mammography data from all clinics in Denmark in the year 2000 were collected and linked to cancer outcome. Use of the National Institute of Radiation Hygiene register for identification of radiology clinics ensured comprehensive nationwide registration. We used the final mammographic assessment at the end of the imaging work-up to determine sensitivity, specificity and accuracy, the latter using a receiver-operating characteristics (ROC) analysis. In 96,534 clinical mammography examinations, sensitivity was 75% and specificity 99%. The presence of at least one high volume-reading radiologist in the clinic increased accuracy (AUC = 0.91 for <1,000 examinations/year and 0.92 for >2,000 examinations/year, p = 0.017). The examination volume per clinic showed no clear effect on performance, as accuracy was significantly higher in clinics with a medium number of examinations (AUC = 0.93 for 2,000-4,000 examinations/year and 0.90 for >6,000 examinations/year, p = 0.003). Accuracy was significantly lower in regions with high annual utilisation rate of clinical mammography, which means the proportion of examined women in a region (AUC = 0.90 for 3.0-5.0% annual utilisation rate and AUC = 0.93 for 2.0-2.5% annual utilisation rate, and p = 0.001), indicating that clinical mammography worked best in patient populations of purely symptomatic women. Our data indicate that to increase the accuracy of clinical mammography at the community level, the presence of an experienced radiologist should be prioritized ahead of raising the clinic size.",
author = "Allan Jensen and Ilse Vejborg and Niels Severinsen and Susanne Nielsen and Fritz Rank and Mikkelsen, {Gerd Just} and J{\o}rgen Hilden and Dorte Vistisen and Uffe Dyreborg and Elsebeth Lynge",
note = "Keywords: Adult; Aged; Aged, 80 and over; Breast Neoplasms; Denmark; False Positive Reactions; Female; Humans; Mammography; Mass Screening; Middle Aged; Physicians; ROC Curve; Sensitivity and Specificity",
year = "2006",
doi = "10.1002/ijc.21811",
language = "English",
volume = "119",
pages = "183--91",
journal = "International Journal of Cancer",
issn = "0020-7136",
publisher = "JohnWiley & Sons, Inc.",
number = "1",

}

RIS

TY - JOUR

T1 - Performance of clinical mammography: a nationwide study from Denmark

AU - Jensen, Allan

AU - Vejborg, Ilse

AU - Severinsen, Niels

AU - Nielsen, Susanne

AU - Rank, Fritz

AU - Mikkelsen, Gerd Just

AU - Hilden, Jørgen

AU - Vistisen, Dorte

AU - Dyreborg, Uffe

AU - Lynge, Elsebeth

N1 - Keywords: Adult; Aged; Aged, 80 and over; Breast Neoplasms; Denmark; False Positive Reactions; Female; Humans; Mammography; Mass Screening; Middle Aged; Physicians; ROC Curve; Sensitivity and Specificity

PY - 2006

Y1 - 2006

N2 - Clinical mammography is the key tool for breast cancer diagnosis, but little is known about the impact of the organisational set-up on the performance. We evaluated whether organisational factors influence the performance of clinical mammography. Clinical mammography data from all clinics in Denmark in the year 2000 were collected and linked to cancer outcome. Use of the National Institute of Radiation Hygiene register for identification of radiology clinics ensured comprehensive nationwide registration. We used the final mammographic assessment at the end of the imaging work-up to determine sensitivity, specificity and accuracy, the latter using a receiver-operating characteristics (ROC) analysis. In 96,534 clinical mammography examinations, sensitivity was 75% and specificity 99%. The presence of at least one high volume-reading radiologist in the clinic increased accuracy (AUC = 0.91 for <1,000 examinations/year and 0.92 for >2,000 examinations/year, p = 0.017). The examination volume per clinic showed no clear effect on performance, as accuracy was significantly higher in clinics with a medium number of examinations (AUC = 0.93 for 2,000-4,000 examinations/year and 0.90 for >6,000 examinations/year, p = 0.003). Accuracy was significantly lower in regions with high annual utilisation rate of clinical mammography, which means the proportion of examined women in a region (AUC = 0.90 for 3.0-5.0% annual utilisation rate and AUC = 0.93 for 2.0-2.5% annual utilisation rate, and p = 0.001), indicating that clinical mammography worked best in patient populations of purely symptomatic women. Our data indicate that to increase the accuracy of clinical mammography at the community level, the presence of an experienced radiologist should be prioritized ahead of raising the clinic size.

AB - Clinical mammography is the key tool for breast cancer diagnosis, but little is known about the impact of the organisational set-up on the performance. We evaluated whether organisational factors influence the performance of clinical mammography. Clinical mammography data from all clinics in Denmark in the year 2000 were collected and linked to cancer outcome. Use of the National Institute of Radiation Hygiene register for identification of radiology clinics ensured comprehensive nationwide registration. We used the final mammographic assessment at the end of the imaging work-up to determine sensitivity, specificity and accuracy, the latter using a receiver-operating characteristics (ROC) analysis. In 96,534 clinical mammography examinations, sensitivity was 75% and specificity 99%. The presence of at least one high volume-reading radiologist in the clinic increased accuracy (AUC = 0.91 for <1,000 examinations/year and 0.92 for >2,000 examinations/year, p = 0.017). The examination volume per clinic showed no clear effect on performance, as accuracy was significantly higher in clinics with a medium number of examinations (AUC = 0.93 for 2,000-4,000 examinations/year and 0.90 for >6,000 examinations/year, p = 0.003). Accuracy was significantly lower in regions with high annual utilisation rate of clinical mammography, which means the proportion of examined women in a region (AUC = 0.90 for 3.0-5.0% annual utilisation rate and AUC = 0.93 for 2.0-2.5% annual utilisation rate, and p = 0.001), indicating that clinical mammography worked best in patient populations of purely symptomatic women. Our data indicate that to increase the accuracy of clinical mammography at the community level, the presence of an experienced radiologist should be prioritized ahead of raising the clinic size.

U2 - 10.1002/ijc.21811

DO - 10.1002/ijc.21811

M3 - Journal article

C2 - 16450388

VL - 119

SP - 183

EP - 191

JO - International Journal of Cancer

JF - International Journal of Cancer

SN - 0020-7136

IS - 1

ER -

ID: 14309359