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Study rates doctors on reading diagnostic mammograms

Study rates doctors on reading diagnostic mammograms

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Dr. Kim Mulvihill reporting How accurate are diagnostic mammograms in determining whether a lump is just a lump or actually breast cancer? According to a new study, a lot depends on who's reading them.

A diagnostic mammogram is done when a problem is suspected in a woman's breast. A radiologist reads the diagnostic X-ray to determine whether the patient undergoes the next step: a biopsy. This new research identifies which radiologists are the most accurate.

The evidence is clear: mammography works. "If you use mammography, it's a good thing. Women have a decreased risk of dying of breast cancer; somewhere 20 to 30 percent decreased risk of dying of breast cancer if you get a mammogram," explained Dr. Rebecca Smith-Bindman.

Smith-Bindman is one of the researchers involved in a new study. The research looked at how accurately radiologists could distinguish a lump from a breast cancer.

Researchers found a stunning variation among radiologists in accurately detecting cancer--they ranged from 27 to 100 percent. As for false positives, unnecessary biopsies were performed from zero to 16 percent of the time.

Those who did the best job were based at academic medical centers or spent at least 20 percent of their time on breast imaging. "It turns out the best mammographers probably biopsy the least, but they also find the most cancers," Dr. Laura Esserman said.

Esserman is director of the Breast Care Center at UCSF. She says more accurate readings mean fewer biopsies and less anxiety for the woman. "Biopsies cause a lot of anxiety and they use up a lot of resources, and it's hard for women, and if there is a good way to do less of them, then I think that's better," she said.

Here's what researchers suggest for women with breast concerns, such as lumps: Try to get evaluated at a center that has at least one breast imaging specialist--a radiologist who spends much of their time reading mammograms and performing breast biopsies.

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