XXXX at biennial screening mammography in the Netherlands: a population-based study.

@entity1 @entity854 @entity5 @entity0
PURPOSE: To determine the incidence of @entity0 at biennial screening mammography and to assess the sensitivity of screening in the detection of @entity0 . MATERIALS AND METHODS: All @entity1 gave written informed consent, and the requirement to obtain review board approval was waived. The authors included all 302,196 screening mammograms obtained in 80,466 @entity1 aged 50-75 years in a southern breast screening region of the Netherlands between May 1998 and July 2008. During 2-year follow-up, the authors collected clinical data, breast imaging reports, biopsy results, and breast surgery reports from all @entity1 with screening-detected and interval @entity5 . Two screening radiologists reviewed the screening and clinical mammograms of all bilateral screening-detected and interval @entity5 for @entity854 . The radiologists were initially blinded to each other's referral opinion, and discrepant assessments were followed by consensus reading. RESULTS: Of all @entity1 with screening-detected @entity5 (n = 1555) or interval @entity5 (n = 585), 52 (2.4%) had @entity0 . The sensitivity of screening mammography in the detection of @entity0 was 19% (10 of 52 @entity1 ; 95% confidence interval: 8.5%, 29.9%). At blinded review, 18 of the 53 @entity5 not detected at screening (34%) were considered to be missed, 11 (21%) showed nonspecific minimal signs, and 24 (45%) had been mammographically occult at screening. Five @entity1 referred for further analysis experienced a 6-17-month delay in the diagnosis of the second @entity0 ; in four of those @entity1 , the delay resulted from an incorrect Breast Imaging Reporting and Data System classification at clinical mammography. CONCLUSION: The sensitivity of screening mammography in the detection of @entity0 is disappointingly low. Both screening radiologists and clinical radiologists should pay vigorous attention to the contralateral breast to detect bilateral @entity5 without diagnostic delay.
