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Doctors' Judgment Still Trumps Mammography Advances

Computer-assisted scans can miss lesions caught by trained eye

MONDAY, Dec. 18, 2006 (HealthDay News) -- While computer-assisted detection (CAD) technology is helpful, it can't replace a doctor's judgment in reading mammograms, say researchers at Group Health Cooperative health system in Seattle.

They noted that radiologists can spot lesions on mammograms that aren't detected by CAD.

"Our study shows that radiologists must continue to rely on their own judgment when determining whether lesions seen on mammograms require further testing," research leader Dr. Stephen Taplin said in a prepared statement.

He conducted the research while at Group Health and is currently a senior scientist at the U.S. National Cancer Institute.

CAD uses computer software to identify and mark areas of concern on mammograms. Typically, radiologists review the CAD-marked images after they interpret the original mammography images.

For this study, 19 radiologists each read 341 mammograms with and without CAD. The technology did not improve the doctors' ability to spot cancer when it was present but did increase (from 72 percent to 75 percent) their ability to determine whether a woman was free of breast cancer and needed no further evaluation

The study also found that when the radiologists viewed CAD-reviewed mammograms with lesions that weren't marked by CAD, the radiologists were less likely to recommend further evaluation than when they detected lesions on mammograms that had not been reviewed by CAD.

"This means that the radiologists may have been deferring to CAD and believing its interpretation rather than their own interpretation," Taplin said.

"This is something the originators of the technology say radiologists should not do. This study shows that it is hard to ignore the technology," he added.

Taplin and his colleagues recommended that radiologists be trained to pay attention to mammogram abnormalities that might be missed by CAD.

The findings are published in the December issue of the American Journal of Roentgenology.

More information

The U.S. National Cancer Institute has more about screening mammograms.

SOURCE: Group Health Cooperative, news release, Dec. 4, 2006
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