Double Reading of Mammograms More Effective

The interpretation of screening mammograms by two readers (double reading) rather than by one reader increased the rate of cancer detection by 4 to 14% in several studies, and by 10% according to a meta-analysis. Double reading is standard practice in at least 12 European countries, but has not been widely adopted in the United States.

The use of computer-aided detection systems has the potential to increase cancer-detection rates. Thus, a single reader using computer-aided detection might be able to match the performance of two readers. Single reading with computer-aided detection could be an alternative to double reading and improve results of single reading.

Computer-aided detection systems use computer algorithms to analyze digital mammographic images. They identify and mark potentially suspicious regions to attract the reader's attention to features that might have been overlooked or dismissed as normal. In the United States, where single reading is standard practice, commercial computer-aided detection systems have been widely adopted to improve reader performance and are used in 25 to 30% of all mammogram readings. However, the benefit of computer-aided detection in screening mammography was recently questioned in an observational study by Fenton, et al, and remains controversial.

Read more about double reading and computer-aided detection at the New England Journal of Medicine