Batch reading mammograms can significantly reduce the number of patients who have to return for additional mammograms

Batch reading, the process of interpreting screening mammograms during a set-aside block of time in a quiet environment that prevents interruption or distraction, can significantly reduce the number of patients who have to return for additional mammograms - although few hospitals use it, say researchers from the University of Wisconsin.

For the study, the researchers analyzed the recall and cancer detection rates for 9,522 screening mammograms, 1,538 of which were interpreted by batch reading. They found that recall rates were 20.1 per cent without batch reading and 16.2 per cent with batch reading and that the accuracy of cancer detection was not adversely affected.

According to the authors, methods of reading screening mammograms can be categorized as batch reading or non-batch reading. Non-batch reading refers to reading screening mammograms in the midst of other duties such as diagnostic mammograms, phone calls, consultations with referring physicians or procedures--in other words, with continual interruptions.

"Experts in the field of breast imaging have long believed that batch reading not only improves performance but contributes to cost-effective breast cancer screening. In 1994, researchers surveyed 1,057 facilities and found that only 20 per cent used batch reading," said Elizabeth S. Burnside, MD, lead author of the study.

It may make sense that interpreting mammograms in a quiet, distraction-free environment would improve performance, but, say the authors, there are many competing pressures in a busy practice. Referring physicians want immediate access to radiologists for consultation on patients who are present in clinic, anxious patients desire immediate interpretation of mammograms and consultation with the interpreting physicians and the shortage of breast imaging specialists require these services be provided by a shrinking pool of individuals. "It is tempting for efficiency sake to fit screening mammograms into the small bits of time between other clinical activities, but our research demonstrates that batch reading contributes to maintaining high cancer detection while decreasing false positive results," said Dr. Burnside.

"This should encourage both the medical community and patients to support this practice. Despite the trade-offs, uninterrupted, distraction-free batch reading appears to be an essential component to high quality, accurate interpretation of screening mammography," said Dr. Burnside.