Performance Benchmarks for Diagnostic Mammography

Sickles EA, Miglioretti DL, Ballard-Barbash R, Geller BM, Leung JWT, Rosenberg RD, Smith-Bindman R, Yankaskas BC. Performance benchmarks for diagnostic mammography. Radiology 2005;235(3):775-790. [Abstract]

In the United States, a Food and Drug Administration (FDA) regulation requires limited auditing of clinical outcomes for all screening and diagnostic mammography examinations that have been assessed as either suspicious for malignancy or highly suggestive of malignancy. More comprehensive auditing is performed by many mammography facilities in both the United States and other countries. Auditing is thought to be a useful quality assurance procedure, providing performance feedback to both mammography facilities and individual interpreting radiologists.

The following tables and figures contain a range of performance parameters pertinent to the comprehensive auditing of diagnostic mammography examinations. These tables and figures contain supplemental information from the published paper listed above. (Note: These data have not been submitted for peer review.) Pooling of these data from BCSC registries provides by far the largest reported experience involving diagnostic mammography practice, from which reasonable and realistic performance benchmarks may be derived.

Tables

Estimates for the following tables are based on 714,984 diagnostic mammography examinations performed between 1996 and 2005 at 153 mammography facilities by 741 interpreting radiologists.

• Clinical Demographics by Indication for Examination for Diagnostic Mammography Examinations, 1996 - 2005
• Abnormal Interpretations by Indication for Examination for Diagnostic Mammography Examinations, 1996 - 2005
• Cancers by Indication for Examination for Diagnostic Mammography Examinations, 1996 - 2005
• Sensitivity and Specificity by Indication for Examination for Diagnostic Mammography Examinations, 1996 - 2005
• Benchmarks for Abnormal Diagnostic Mammography Interpretations by Indication for Examination, 1996 - 2005
• Benchmarks for Cancers by Indication for Examination for Diagnostic Mammography Examinations, 1996 - 2005
• Benchmarks for Sensitivity and Specificity by Indication for Examination for Diagnostic Mammography Examinations, 1996 - 2005

Figures

The following figures display smoothed plots of frequency distributions for performance parameters as a function of indication for examination.

1. Smoothed Plots of Frequency Distributions of Abnormal Interpretation Rates for 611,154 Diagnostic Mammography Examinations (Among Radiologists with Ten or More Examinations), 1996 - 2005
2. Smoothed Plots of Frequency Distributions of PPV₁ for 57,707 Diagnostic Mammography Examinations with Abnormal Findings (Among Radiologists with Ten or More Examinations with Abnormal Findings), 1996 - 2005
3. Smoothed Plots of Frequency Distributions of PPV₂ for 54,456 Diagnostic Mammography Examinations with Abnormal Results for Which Biopsy was Recommended (Among Radiologists with Ten or More Biopsies Recommended), 1996 - 2005
4. Smoothed Plots of Frequency Distributions of PPV₃ for 40,948 Diagnostic Mammography Examinations with Abnormal Results for Which Biopsy was Recommended and Performed (Among Radiologists with Ten or More Biopsies Performed), 1996 - 2005
5. Smoothed Plots of Frequency Distributions of Cancer Diagnosis Rates for 604,365 Diagnostic Mammography Examinations (Among Radiologists with 100 or More Examinations), 1996 - 2005
6. Smoothed Plots of Frequency Distributions of Invasive Cancer Size for 12,510 Invasive Cancers of Known Size That Were Identified at Diagnostic Mammography (Among Radiologists Finding Five or More Invasive Cancers of Known Size), 1996 - 2005
7. Smoothed Plots of Frequency Distributions of Minimal Cancer Percentage for 16,220 DCIS and Invasive Cancers of Known Size That Were Identified at Diagnostic Mammography (Among Radiologists Finding Five or More DCIS and Invasive Cancers of Known Size), 1996 - 2005
8. Smoothed Plots of Frequency Distributions of Node-Negative Percentage for 13,890 Invasive Cancers That Were Identified at Diagnostic Mammography (Among Radiologists Finding Five or More Invasive Cancers of Known Nodal Status), 1996 - 2005
9. Smoothed Plots of Frequency Distributions of Stage 0 or I Percentage for 15,817 Cancers of Known Stage That Were Identified at Diagnostic Mammography (Among Radiologists Finding Five or More Cancers of Known Stage), 1996 - 2005
10. Smoothed Plots of Sensitivity by Indication for Examination for 21,109 Cancers That Were Identified at Diagnostic Mammography (Among Radiologists Finding Five or More Cancers), 1996 - 2005
11. Smoothed Plots of Specificity by Indication for Examination for 582,193 Non-cancers (Among Radiologists Finding 100 or More Non-Cancers), 1996 - 2005