CORRESPONDENCE

Re: Short-Interval Follow-Up Mammography: Are We Doing the Right Thing?

Shagufta Yasmeen, Patrick S. Romano, Mary Pettinger, Rowan T. Chlebowski, John A. Robbins, Dorothy S. Lane, Susan L. Hendrix

Affiliations of authors: S. Yasmeen, P. S. Romano, J. A. Robbins, University of California, Davis, Davis; M. Pettinger, Women’s Health Initiative Clinical Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WA; R. T. Chlebowski, Harbor–University of California at Los Angeles Research and Education Institute, Torrance, CA; D. S. Lane, State University of New York, Stony Brook; S. L. Hendrix, Wayne State University, Detroit, MI.

Correspondence to: Shagufta Yasmeen, MD, University of California, Davis, Department of Obstetrics/Gynecology and Internal Medicine, 4860 Y St., Suite 2500, Sacramento, CA 95817 (e-mail: syasmeen{at}ucdavis.edu).

We are writing in general support of the conclusions of the editorial regarding short-interval follow-up mammography by Kerlikowske et al. (1), which was written in response to our recent report of this issue based on findings from the Women’s Health Initiative (2). Kerlikowske et al. concluded that if the prevalence of probably benign lesions that are recommended for short-interval follow-up is in the range we reported, a large number of women may be undergoing unnecessary surveillance of benign lesions. However, the authors also offered several potential explanations for our results, including improper use of the Breast Imaging Reporting and Data System (BI-RADS) category 3 ("probably benign findings–short-interval follow-up suggested") assessment by the participating radiologists and the unavailability of comparison films, which they suggest should limit the impact of our findings on clinical practice. Although we did not provide details of the associated procedures accompanying the recommendations of short-interval follow-up, our findings nonetheless reflect a broad spectrum of contemporary clinical practice. The mammographic recommendations reflected the practice of radiologists at more than 3000 hospitals, clinics, and imaging centers that provided mammography for the 40 Women’s Health Initiative clinical centers. Our results, rather than reflecting unique characteristics of a particular clinical trial, are likely to represent a snapshot of current clinical use of the BI-RADS category 3 assessment (2). We certainly concur with the suggestion by Kerlikowske et al. that a better understanding of how radiologists use the BI-RADS category 3 assessment in practice is needed. We feel that our recent report provides an initial approach to this understanding.

REFERENCES

1 Kerlikowske K, Smith-Bindman R, Sickles EA. Short-interval follow-up mammography: are we doing the right thing? J Natl Cancer Inst 2003;95:418–9.[Free Full Text]

2 Yasmeen S, Romano PS, Pettinger M, Chlebowski RT, Robbins JA, Lane DS, et al. Frequency and predictive value of a mammographic recommendation for short-interval follow-up. J Natl Cancer Inst 2003;95:429–36.[Abstract/Free Full Text]



             
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