How Does the Perception of a Lesion Influence Visual Search Strategy in Mammogram Reading?

A true malignant mass that the observers correctly report may be perceived immediately after image onset, thus biasing background sampling from the start, whereas areas that yield both false-negative and false-positive decisions may only be perceived during visual examination of the parenchyma. For the false negatives, our data suggest that after fixating the location of the lesion, the observers actively tried to reconcile the perception of the lesion with its background, whereas for the false positives, which represent a “true” lesion for the observers, background sampling was clearly different before and after the location was fixated for the first time. Hence, the perception of a finding effectively biases any further analysis of the case.