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Optimal Reference Mammography: A Comparison of Mammograms Obtained 1 and 2 Years Before the Present Examination

¹ Department of Radiology, Imaging Research, Ste. 4200, University of Pittsburgh, and Magee-Womens Hospital, 300 Halket St., Pittsburgh, PA 15213.
² Present address: Department of Radiology, Scott & White Clinic, 2401 S. 31st St., Tempe, TX 76508.

OBJECTIVE. We assessed and compared the benefit of using images acquired 1 year or 2 years previously during mammography interpretations.

MATERIALS AND METHODS. Eleven radiologists and one resident reviewed 128 cases three times: once without prior mammograms for comparison, once with mammograms from the most recent (1 year) examination, and once with mammograms acquired 2 years previously. They were asked to determine whether the patient should be recalled for additional procedures. Performances under the three conditions were compared.

RESULTS. Radiologists were significantly more accurate (p < 0.001) when comparison mammograms (obtained 1 or 2 years previously) were available. Although sensitivity was not significantly affected between the availability of mammograms from 1 or 2 years earlier (p > 0.10), the specificity was. Specificity using mammograms from the latest examination (obtained 1 year previously) as a reference was significantly better (p = 0.03) than specificity using mammograms obtained 2 years previously.

CONCLUSION. Comparison mammograms are important for accurate diagnosis—in particular, for increasing specificity. The latest prior examination seems to be the optimal one for this purpose.

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