Critical Assessment of Mammography Accuracy

Mammography is currently considered the gold standard for breast screening, despite painful breast compression, invasive radiation exposure and excessive infrastructure and personnel requirements, contributing to its inequity. Furthermore, sensitivity and specificity of mammog-raphy are often overstated by studies utilising flawed methodology. This paper critically reviews the literature reporting on methods used to calculate diagnostic accuracy of mammography. Values for sensitivity, specificity and receiver operator characteristic (ROC) curve area (AUC) are presented by averaging results from studies inclusive of a comparison to another breast screening modality. The result is mammography sensitivity of 60%, specificity of 80%, AUC of 0.73. These values should be used when assessing diagnostic performance of other breast screening technologies.