Digital mammographic interpretation by UK radiographer mammographers: A JAFROC analysis of observer performance

Introduction: Radiologists utilise mammography test sets to bench mark their performance against recognised standards. Using a validated test set, this study compares the performance of radiographer readers against previous test results for radiologists. Methods: Under similar test conditions radiographer readers were given an established test set of 60 mammograms and tasked to identify breast cancer, they were measured against their ability to identify, locate and give a confidence level for cancer being present on a standard set of mammographic images. The results were then compared to previously published results for radiologists for similar or the same test sets. Results: The 10 radiographer readers demonstrated similar results to radiologists and for lesion sensitivity were the highest scoring group. The study group score a sensitivity of 83; a specificity of 69.3 and lesion sensitivity of 74.8 with ROC and JAFROC scores of 0.86 and 0.74 respectively. Conclusion: Under test conditions radiographers are able to identify and accurately locate breast cancer in a range of complex mammographic backgrounds. Implications for practice: The study was performed under experimental conditions with results comparable to breast radiologists under similar conditions; translation of these findings into clinical practice will help address access and capacity issues in the timely identification and diagnosis of breast cancer