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May 26, 1993

Varied Mammogram Readings Worry Researchers

JAMA. 1993;269(20):2616-2617. doi:10.1001/jama.1993.03500200026012

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CLINICIANS have long recognized that mammography's precision as a diagnostic tool can be hampered by its technical limitations. Yet a recent study in which 10 seasoned radiologists reviewed an identical set of high-quality mammograms of 150 patients suggests that some imprecision can stem in part from variations in the eyes of the beholders.

The study, which was conducted by investigators at Yale University School of Medicine, New Haven, Conn, revealed a disturbing variability in the radiologists' diagnostic interpretations, clinical accuracies, and management recommendations.

The radiogists had major clinical disagreements in their diagnoses of the results (ie, normal or abnormal-benign vs cancer) in 33% of the patients. And they disagreed radically in their management recommendations (ie, routine mammogram follow-up vs biopsy) in 25% of the patients.

The researchers, led by principal investigator Alvan R. Feinstein, MD, Sterling Professor of Medicine and Epidemiology at Yale, presented their findings this month at the