Resumen

Objective: Mammographic interpretation using the BIRADS system determines if a patient must continue in the regular screening program or needs additional studies for breast cancer diagnosis, hence the importance of its accurate evaluation. Sensitivity, specificity, diagnostic accuracy of mammographic interpretation and inter- and intra-observer variation, were assessed in a random sample of 29 radiologists from the Mexican Ministry of Health. Material and methods: Eighty diagnostic and screening mammographic studies were selected from the National Cancer Institute in Mexico City. Under equal conditions, two interpretations using the BI-RADS system were performed by each of the participating radiologists. Results: Sensitivity in the first and second measurement was 72 and 74% respectively, while the specificity was 80% for the first and 82% for second. Multivariate analysis showed a positive association between the preceding year’s volume of interpreted mammograms, the number of courses taken and diagnostic accuracy (β = 0.00002, 95% CI 0.000004, 0.00003, p = 0.02, β = 0.005, CI 95 % -0.0004, 0.01, p = 0.07, respectively). Interobserver agreement was low in both measurements (κ = 0.24, κ = 0.25, respectively). However, after combining BI-RADS categories in 2 groups, agreement increased to 0.46 for both measurements. The intra-observer agreement was good (κ = 0.67). Conclusions: The number of mammographic studies interpreted during the last year is a good measure of the experience of the radiologist, wich is reflected in the diagnostic accuracy of mammographic interpretation. Periodic tranning courses on mammographic interpretation also have a positive impact on performance.

Palabras clave: BI-RADS. Reliability. Breast cancer. Sensitivity. Specificity.

2013-07-24   |   791 visitas   |   Evalua este artículo 0 valoraciones

Vol. 63 Núm.2. Marzo-Abril 2011 Pags. 124-134 Rev Invest Clin 2011; 63(2-ENGLISH)