Education, testing crucial for successful mammography screeners
Introducing better ways to test and train radiologists in mammography remains an ongoing challenge, but 2 promising projects were demonstrated during the recent National Workshop on Organized Breast Cancer Screening Programs in Ottawa.
Cupido Daniels, a professor of radiology at Dalhousie University and head of the Diagnostic Medical Physics Division at the Queen Elizabeth II Health Sciences Centre in Halifax, has developed a series of radiology CD-ROMs, including one entitled Fundamentals of Breast Imaging. "This is the only one of its kind in Canada," he said in an interview, "and I have had excellent feedback on it."
The computer program provides instruction on several related topics, including epidemiology, reading a mammogram, quality assurance, pathology, male breasts and case studies. It allows students to learn at their own pace and does not take limited teaching time away from clinical staff. The CD-ROM is now available commercially.
Dr. Paula Gordon, a radiologist with British Columbia's Screening Mammography Program, demonstrated that program's standardized mammography reading test for screeners. "No other province has this test," she said. "To work in our program, a radiologist must be reading a minimum number of mammograms per week, and pass this test."
Comprising a mixture of 100 actual breast films, the test requires doctors to distinguish healthy tissue, cancerous tissue and abnormal benign tumours. "The test is designed to measure a radiologist's sensitivity -- the ability to find cancer when it is present -- and specificity -- the ability to read the film accurately," explained Gordon. "If you read 100 films and recall all 100 women, your sensitivity is considered very high because you have not missed any cancers. But you have caused enormous anxiety in all the healthy women, so your specificity is zero. You want to keep your call back rate as low as possible."
To pass the test, radiologists' sensitivity score must be above 85%, and specificity above 65%.
