Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Performance of Screening Mammography: A Report of the Alliance for Breast Cancer Screening in Korea

  • Lee, Eun Hye (Department of Radiology, Bucheon Hospital, Soonchunhyang University College of Medicine) ;
  • Kim, Keum Won (Department of Radiology, Konyang University Hospital, Konyang University College of Medicine) ;
  • Kim, Young Joong (Department of Radiology, Konyang University Hospital, Konyang University College of Medicine) ;
  • Shin, Dong-Rock (Department of Radiology, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Park, Young Mi (Department of Radiology, Busan Paik Hospital, Inje University College of Medicine) ;
  • Lim, Hyo Soon (Department of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University College of Medicine) ;
  • Park, Jeong Seon (Department of Radiology, Hanyang University Hospital, Hanyang University College of Medicine) ;
  • Kim, Hye-Won (Department of Radiology, Wonkwang University Hospital, Wonkwang University School of Medicine) ;
  • Kim, You Me (Department of Radiology, Dankook University Hospital, Dankook University College of Medicine) ;
  • Kim, Hye Jung (Department of Radiology, Kyungpook National University Hospital, Kyungpook National University College of Medicine) ;
  • Jun, Jae Kwan (National Cancer Control Institute, National Cancer Center)
  • Received : 2015.11.08
  • Accepted : 2016.03.15
  • Published : 2016.07.01
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Abstract

Objective: To analyze the diagnostic accuracy and trend in screening mammography in Korea. Materials and Methods: We retrospectively linked the information from hospitals participating in the Alliance of Breast Cancer Screening in Korea (ABCS-K) and the database of the National Cancer Screening Program. We calculated performance indicators, including the recall rate, cancer detection rate (CDR), positive predictive value (PPV), sensitivity, specificity, false-positive rate (FPR), and interval cancer rate (ICR). Changes in the performance indicators were calculated as the annual percent change with 95% confidence interval (CI). Results: We enrolled 128756 cases from 10 hospitals from 2005 to 2010. The recall rate was 19.1% with a downward trend over time (-12.1% per year; 95% CI, -15.9 to -8.2). The CDR was 2.69 per 1000 examinations, without a significant trend. The PPV was 1.4% with an upward trend (20.8% per year; 95% CI, 15.2 to 26.7). The sensitivity was 86.5% without a significant trend, whereas the specificity was 81.1% with an upward trend (3.3% per year; 95% CI, 2.1 to 4.5). The FPR was 18.9% with a downward trend (-12.4% per year; 95% CI, -16.2 to -8.4). The ICR was 0.5 per 1000 negative examinations without a significant trend. There were institutional variations in the diagnostic accuracy and trend except for the CDR, sensitivity, and ICR. Conclusion: The sensitivity and CDR of screening mammography in the ABCS-K from 2005 to 2010 were compatible with those for Western women. The recall rate, PPV and specificity, however, were suboptimal, although they showed significant improvements over this period. A further analysis is required to explain institutional variations.

Keywords

Acknowledgement

Supported by : Ministry of Health & Welfare

References

  1. Jung KW, Won YJ, Kong HJ, Oh CM, Cho H, Lee DH, et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2012. Cancer Res Treat 2015;47:127-141 https://doi.org/10.4143/crt.2015.060
  2. Kim Y, Jun JK, Choi KS, Lee HY, Park EC. Overview of the National Cancer screening programme and the cancer screening status in Korea. Asian Pac J Cancer Prev 2011;12:725-730
  3. Suh M, Choi KS, Lee YY, Jun JK. Trends in cancer screening rates among Korean men and women: results from the Korean National Cancer screening survey, 2004-2012. Cancer Res Treat 2013;45:86-94 https://doi.org/10.4143/crt.2013.45.2.86
  4. Kang MH, Park EC, Choi KS, Suh M, Jun JK, Cho E. The National Cancer Screening Program for breast cancer in the Republic of Korea: is it cost-effective? Asian Pac J Cancer Prev 2013;14:2059-2065 https://doi.org/10.7314/APJCP.2013.14.3.2059
  5. Choi NM, Lee AL, Lee HK, Yi BH, Cha JG. Mammogrphic screening provided by the National Health Insurance Corporation: a 1 year audit in a secondary medical institution. J Korean Soc Radiol 2009;60:51-55 https://doi.org/10.3348/jksr.2009.60.1.51
  6. D'Orsi CJ, Bassett LW, Berg WA, Feig SA, Jackson VP, KopanDB, et al. BI-RADS: mammography. In: D'Orsi CJ, Mendelson EB, Ikeda DM, eds. $BI-RADS^{(R)}$ breast imaging and reporting data system: breast imaging atlas, 4th ed. Reston: American College of Radiology, 2003
  7. Kim HJ, Fay MP, Feuer EJ, Midthune DN. Permutation tests for joinpoint regression with applications to cancer rates. Stat Med 2000;19:335-351 https://doi.org/10.1002/(SICI)1097-0258(20000215)19:3<335::AID-SIM336>3.0.CO;2-Z
  8. Ahn HS, Kim SM, Jang M, Yun BL, Kim B, Ko ES, et al. A new full-field digital mammography system with and without the use of an advanced post-processing algorithm: comparison of image quality and diagnostic performance. Korean J Radiol 2014;15:305-312 https://doi.org/10.3348/kjr.2014.15.3.305
  9. Ko SY, Kim EK, Kim MJ, Moon HJ. Mammographic density estimation with automated volumetric breast density measurement. Korean J Radiol 2014;15:313-321 https://doi.org/10.3348/kjr.2014.15.3.313
  10. Kim SA, Chang JM, Cho N, Yi A, Moon WK. Characterization of breast lesions: comparison of digital breast tomosynthesis and ultrasonography. Korean J Radiol 2015;16:229-238 https://doi.org/10.3348/kjr.2015.16.2.229
  11. Lee EH, Jung SE. Current status of radiologists' part-time services in mammography. J Korean Soc Breast Screen 2012;9:142-147
  12. Sickles EA, D'Orsi CJ. ACR $BI-RADS^{(R)}$ follow-up and outcome monitoring. In: D'Orsi CJ, Sickles EA, Mendelson EB, Morris EA, eds. ACR $BI-RADS^{(R)}$ atlas breast imaging reporting and data system. Reston, VA: American College of Radiology, 2013
  13. Mandelson MT, Oestreicher N, Porter PL, White D, Finder CA, Taplin SH, et al. Breast density as a predictor of mammographic detection: comparison of interval-and screen-detected cancers. J Natl Cancer Inst 2000;92:1081-1087 https://doi.org/10.1093/jnci/92.13.1081
  14. Stomper PC, D'Souza DJ, DiNitto PA, Arredondo MA. Analysis of parenchymal density on mammograms in 1353 women 25-79 years old. AJR Am J Roentgenol 1996;167:1261-1265 https://doi.org/10.2214/ajr.167.5.8911192
  15. Suzuki A, Kuriyama S, Kawai M, Amari M, Takeda M, Ishida T, et al. Age-specific interval breast cancers in Japan: estimation of the proper sensitivity of screening using a population-based cancer registry. Cancer Sci 2008;99:2264-2267 https://doi.org/10.1111/j.1349-7006.2008.00926.x
  16. Lee EH, Jun JK, Kim YM, Bae K, Hwang KW, Choi BB, et al. Mammography boot camp to improve a quality of national cancer screening program in Korea: a report about a test run in 2012. J Korean Soc Breast Screen 2013;10:162-168
  17. Lee EH, Jun JK, Jung SE, Kim YM, Choi N. The efficacy of mammography boot camp to improve the performance of radiologists. Korean J Radiol 2014;15:578-585 https://doi.org/10.3348/kjr.2014.15.5.578

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