Posted: November 11, 2015

Does the volume of mammography  done at an institution have an effect on the quality of the work done?  A recent important study was virtually overlooked by the general medical community because it was published in a journal not read by most main-stream physicians: the Journal of Medical Screening.   The authors looked at 116 medical institutions in the US and compared the stages of breast cancers found to the number of procedures done.  Simply put if the institution performed over 5000 mammograms per year, a cancer found at a screening event was likely to be smaller and have fewer involved lymph nodes than a cancer discovered at an institution that performed fewer studies.   The odds ratio for finding a good prognosis tumor was 1.32, a highly significant number, for centers doing more than 5000 studies/year versus those doing fewer than 2000.   What is the significance of these findings?  Simply put: if you go to one of the high-volume institutions if you have cancer the radiologist is more likely to find it when it is small than if you go to a low volume place.  This has huge implications for the public at large.  If you have a choice, all other things being equal (and the public is unlikely to know whether those things — such as the age of the equipment — are in fact equal) you should have your screening done at a facility that does a lot of mammograms.  For those reading this posting who wish to see the abstract of the article, click here.  If you want the entire article Dr. Stark can email it to you.  He can’t post it only for copyright reasons.