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Mammographers’ Perception of Women’s Breast Cancer Risk

Division of General Internal Medicine, University of Washington School of Medicine, Harborview Medical Center, Seattle, WA

Gary R. Cutter, PhD

Center for Research Design and Statistical Methods, University of Nevada School of Medicine, Reno, NV

Patricia A. Carney, PhD

Department of Community and Family Medicine, Dartmouth Medical School, Lebanon, NH

Stephen H. Taplin, MD, MPH

National Cancer Institute, Applied Research Program, Bethesda, MD

William E. Barlow, PhD

Center for Health Studies, Group Health Cooperative, Seattle, WA

R. Edward Hendrick, PhD

The Lynn Sage Comprehensive Breast Center, Northwestern University Medical School, Chicago, IL

Carl J. D’Orsi, MD

Breast Imaging Center, Emory Health Care Services, Atlanta, GA

Jessica S. Fosse, MPH

Division of General Internal Medicine, University of Washington School of Medicine, Harborview Medical Center, Seattle, WA

Linn Abraham, MS

Center for Health Studies, Group Health Cooperative, Seattle, WA

Joann G. Elmore, MD, MPH

Division of General Internal Medicine, University of Washington School of Medicine, Harborview Medical Center, Seattle, WA, jelmore{at}u.washington.edu

Objective. To understand mammographers’ perception of individual women’s breast cancer risk. Materials and Methods. Radiologists interpreting screening mammography examinations completed a mailed survey consisting of questions pertaining to demographic and clinical practice characteristics, as well as 2 vignettes describing different risk profiles of women. Respondents were asked to estimate the probability of a breast cancer diagnosis in the next 5 years for each vignette. Vignette responses were plotted against mean recall rates in actual clinical practice. Results. The survey was returned by 77% of eligible radiologists. Ninety-three percent of radiologists overestimated risk in the vignette involving a 70-year-old woman; 96% overestimated risk in the vignette involving a 41-year-old woman. Radiologists who more accurately estimated breast cancer risk were younger, worked full-time, were affiliated with an academic medical center, had fellowship training, had fewer than 10 years experience interpreting mammograms, and worked more than 40% of the time in breast imaging. However, only age was statistically significant. No association was found between radiologists’ risk estimate and their recall rate. Conclusion. U.S. radiologists have a heightened perception of breast cancer risk.

Key Words: perception • risk • pretest probability

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