Abstract

Purpose: The 8th edition of the American Joint Committee on Cancer staging system incorporates clinical prognostic staging in addition to the traditionally known anatomic staging of breast cancer. To our knowledge, no study has explored the impact that radiologist’s number of years practicing, breast imaging fellowship training, or practicing dedicated breast imaging, may have on the clinical prognostic stage of breast cancers detected during routine mammography in asymptomatic women.

Material and methods: An IRB-approved, observational study was conducted over a six-year period at a single, safety-net, breast-imaging center. All asymptomatic patients with a diagnosis of breast cancer initially detected during routine mammography performed at the center were included. Data was collected for patients and for radiologists. A generalized linear model for a Poisson distributed dependent variable was used. P-values for between group comparisons were calculated. Chi-square test was used to analyze the grouping variables. Pearson chi square p-value or an exact chi square p-value was used.  A 0.05 alpha level was used to determine statistical significance. Results: Data was available for 251 patients and 12 radiologists. There were no significant differences in type or characteristic of imaging findings at cancer diagnosis, availability of prior mammogram, digital breast tomosynthesis at detection and prognostic clinical stage.

Conclusion:  At our institution, clinical prognostic stage at diagnosis of breast cancers detected during routine mammography in asymptomatic women does not differ by radiologists’ characteristics.