Solis Mammography, the nation’s largest independent provider of breast imaging services, takes issue with incorrectly interpreted terminology used by reporters and others – such as referring to a mammogram callback as a “false positive.” Case in point: a study published Feb. 9 in the journal Cancer Epidemiology, Biomarkers & Prevention referred to mammography recalls as false positive mammograms. This led to news reports across the country stating that a false positive was defined as “a doctor telling a woman that cancer is present, but it turns out not to be.” This is more than a simple misspeak on the part of a reporter. It’s a common misunderstanding and is blatantly false.
A callback is NOT a false positive
After a woman has completed her annual well woman mammogram (2-D or 3-D), the images are viewed and interpreted by a radiologist with about 90 percent of all screenings being negative for breast issues, if read by a specialized breast radiologist. However, if the radiologist can’t see something clearly (sometimes due to dense breast tissue) or sees something that they feel needs a second look, the radiologist will ask the patient to return for more tests, otherwise known as a callback. The radiologist is not saying the first mammogram was a positive indicator for cancer. Rather, he/she is simply stating the need for a closer look – a more magnified view of a particular area (a diagnostic mammogram) – in order to make an accurate recommendation/diagnosis.
Of the small percentage of patients who are called back, on average only 10 percent of those callbacks result in the need for further testing like an ultrasound or biopsy. And even if no additional tests are needed, the recall may simply identify an area that needs observation year over year as a woman’s breast tissue experiences natural changes.
“A callback does not mean a positive finding of cancer,” said James Polfreman, president and CEO, Solis Mammography. “A ‘false positive’ result is medical jargon. Those in the healthcare community understand what it means, but someone unfamiliar with the clinical definition is easily misled to assume it means a misdiagnosis of cancer. Understanding that too many women already avoid mammograms because of fear and anxiety, the term ‘false positives’ should cease to be used in order to help educate women about the importance of regular, annual screening – even when it might result in a callback for additional views.”
All screening providers are not created equal
Clinical research, as published in Radiology, shows there is a significant difference in mammography accuracy between general radiologists and those who specialize in breast imaging. Mammography is most accurate when performed in a breast center with fellowship-trained, specialized breast radiologists; by radiologists who read a high volume of both screening and diagnostic mammograms; and by facilities who employ “batch reading” to interpret screening mammograms without interruption.1 Of the approximately 27,000 radiologists in the U.S., less than 5 percent (or 1,350) meet this standard of mammography focus.2
A specialized breast radiologist typically delivers patients a recall rate substantially lower than that of a generalist radiologist. While the national recall rate for a 2-D screening mammogram is on average 10 to
13 percent, at breast-dedicated centers like Solis Mammography, recall rates are much lower – less than 8 percent on average with no change in cancer detection rates.
In 2013, peer-reviewed research, co-authored by Solis Mammography Chief Medical Officer Dr. Stephen Rose, demonstrated that 3-D mammography (also known as tomosynthesis) increased early detection of breast cancer by 54 percent and reduced recall rates by 37 percent. That 37 percent decrease in callbacks saves patients time and money, but more importantly – reduces unnecessary stress and anxiety. This is a key reason why Solis Mammography has invested more than $18 million since 2014 to upgrade all of their centers to offer 3-D mammography.
Dense breast tissue impacts a patients recall percentage. 3-D mammography is substantially better at screening dense breast tissue than 2-D mammography. Women who have denser breast tissue tend to be younger. Dense breast tissue tends to have less fatty tissue and more non-fatty (milk glands, milk ducts and supportive tissue). Fatty tissue appears gray, while dense glandular tissue and breast cancer appear white on a mammogram. By providing the equivalent of 60 1-inch “slices” of breast tissue views, 3-D mammography helps radiologists better differentiate a problematic mass from simple overlying glandular tissue.
How to minimize recall statistics:
- Opt for a 3-D versus 2-D screening mammogram. While studies have proven that ALL women can greatly benefit from 3-D mammography, it is especially helpful if a patient has presented with dense breast tissue, has a strong family history of breast cancer or has previously experienced frequent callbacks.
- Choose a breast center instead of a general imaging center.
- Ask the radiologist reading the mammogram, and the technologists performing the compression, if they are breast-imaging specialists. This expertise makes a big difference in accurate diagnoses and minimizes unnecessary discomfort during the screening exam.
- Ask for the screening facility’s recall rate prior to booking the appointment and compare it to the national benchmark.
- Inquire if the radiologist employs batch reading to interpret mammograms.
- Supply the radiologist with previous mammogram images.
At Solis Mammography, they understand that no one wants a mammogram – what they want is the peace of mind that comes with knowing their screening was exceptionally accurate, and that they can trust the results. For most women, that result will be a clean bill of health. For those who discover an issue, early detection is key to long-term survival and also to quality of life – offering the potential for less invasive treatment options. What women need most when it comes to mammography is accurate information. Knowledge is power, and inaccurate reports around “false positives” do women and the field of mammography a real disservice.
About Solis Mammography
With more than 30 years in breast imaging, Solis Mammography is a specialized healthcare provider focused on delivering women an exceptional mammography experience. Headquartered in Addison, Texas, Solis currently operates 38 centers across six major markets – North Texas; Houston, Texas; Phoenix, Arizona; Columbus, Ohio; Greensboro, North Carolina; and through its acquisition of Washington Radiology, the District of Columbia metropolitan area. The company operates both wholly-owned centers and multiple successful joint ventures with hospital partners. Solis Mammography (including Washington Radiology), serves more than 600,000 patients each year with highly-specialized imaging services including screening and diagnostic mammography (2-D and 3-D), computer-aided detection, breast ultrasound, stereotactic biopsy and ultrasound-guided biopsy. For more information, visit www.SolisMammo.com, like us on Facebook, follow us on Pinterest, and subscribe to our YouTube channel.
Barbara Jacoby is an award winning blogger that has contributed her writings to multiple online publications that have touched readers worldwide.