Korean J Radiol.  2016 Aug;17(4):489-496. 10.3348/kjr.2016.17.4.489.

Performance of Screening Mammography: A Report of the Alliance for Breast Cancer Screening in Korea

• Lee EH
• Kim KW
• Kim YJ
• Shin DR
• Park YM
• Lim HS
• Park JS
• Kim HW
• Kim YM
• Kim HJ
• Jun JK

• KMID: 2455419
• DOI: http://doi.org/10.3348/kjr.2016.17.4.489

Abstract

OBJECTIVE
To analyze the diagnostic accuracy and trend in screening mammography in Korea.
MATERIALS AND METHODS
We retrospectively linked the information from hospitals participating in the Alliance of Breast Cancer Screening in Korea (ABCS-K) and the database of the National Cancer Screening Program. We calculated performance indicators, including the recall rate, cancer detection rate (CDR), positive predictive value (PPV), sensitivity, specificity, false-positive rate (FPR), and interval cancer rate (ICR). Changes in the performance indicators were calculated as the annual percent change with 95% confidence interval (CI).
RESULTS
We enrolled 128756 cases from 10 hospitals from 2005 to 2010. The recall rate was 19.1% with a downward trend over time (-12.1% per year; 95% CI, -15.9 to -8.2). The CDR was 2.69 per 1000 examinations, without a significant trend. The PPV was 1.4% with an upward trend (20.8% per year; 95% CI, 15.2 to 26.7). The sensitivity was 86.5% without a significant trend, whereas the specificity was 81.1% with an upward trend (3.3% per year; 95% CI, 2.1 to 4.5). The FPR was 18.9% with a downward trend (-12.4% per year; 95% CI, -16.2 to -8.4). The ICR was 0.5 per 1000 negative examinations without a significant trend. There were institutional variations in the diagnostic accuracy and trend except for the CDR, sensitivity, and ICR.
CONCLUSION
The sensitivity and CDR of screening mammography in the ABCS-K from 2005 to 2010 were compatible with those for Western women. The recall rate, PPV and specificity, however, were suboptimal, although they showed significant improvements over this period. A further analysis is required to explain institutional variations.

Keyword

Breast; Breast neoplasms; Mammography; Mass screening

MeSH Terms

Adult
Aged
Breast Neoplasms/*diagnosis
Databases, Factual
Early Detection of Cancer
Female
Humans
*Mammography
Mass Screening
Middle Aged
Reproducibility of Results
Republic of Korea
Retrospective Studies
Sensitivity and Specificity

Figure

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  Fig. 1 Participating institutions of Alliance for Breast Cancer Screening in Korea.Alliance comprises 11 institutions: one as statistical coordinating center (A) and 10 participating in NCSP (B-K). NCSP = National Cancer Screening Program

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  Fig. 2 Study population of Alliance for Breast Cancer Screening in Korea.CAD = computer-aided detection, ID = identification number of hospital, MMG = mammography, NCSP = National Cancer Screening Program

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