Is radiologists' volume of mammography reading related to accuracy? A critical review of the literature

The current UK quality assurance guidelines for radiologists in the NHS breast screening programme require those reporting screening mammograms to read a minimum of 5000 cases per year. We aimed to review the evidence for this and to assess whether there was justification for lowering the required level. A literature search was conducted to identify relevant studies where accuracy of reporting mammograms was related to reading volume. Three of the five studies reviewed suggested a positive association between reading volume and sensitivity, but there were few data on volumes above 5000 cases per year. The available evidence did not provide any basis for reducing the threshold volume. Further work is needed, in a UK or European setting, to study the relationship between reading volume and accuracy at higher volume levels and also the separate effects of reading volume and reading experience.