ArticleBreast cancer (Tokyo, Japan)2024
Inter- and intra-observer variability of qualitative visual breast-composition assessment in mammography among Japanese physicians: a first multi-institutional observer performance study in Japan.
Article in Breast cancer (Tokyo, Japan), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Evaluating artificial intelligence-generated synthesized mammography as a standalone alternative to digital mammography with or without tomosynthesis.Japanese journal of radiology · 2026Article
- Interobserver variability of recall decisions between mammography readers in the English NHS breast screening programme: A comparison of interobserver variability measures.European journal of radiology · 2026Article
- Bridging across the pacific: overview of the 33rd annual meeting of the Japanese breast cancer society.Breast cancer (Tokyo, Japan) · 2026Review
- A novel quantification method for automatic computation of breast density from mammography images using deep learning.Breast cancer (Tokyo, Japan) · 2026Article
- Multimodal artificial intelligence for subepithelial lesion classification and characterization: a multicenter comparative study (with video).BMC medical informatics and decision making · 2025Article
- A New Breast Density Assessment Method Using Portable Document Format.Asian Pacific journal of cancer prevention : APJCP · 2024Article
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Authors and funding
14 authors.
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Abstract
backgroundVisual assessment of mammographic breast composition remains the most common worldwide, although subjective variability limits its reproducibility. This study aimed to investigate the inter- and intra-observer variability in qualitative visual assessment of mammographic breast composition through a multi-institutional observer performance study for the first time in Japan.
methodsThis study enrolled 10 Japanese physicians from five different institutions. They used the new Japanese breast-composition classification system 4th edition to subjectively evaluate the breast composition in 200 pairs of right and left normal mediolateral oblique mammograms (number determined using precise sample size calculations) twice, with a 1-month interval (median patient age: 59 years [range 40-69 years]). The primary endpoint of this study was the inter-observer variability using kappa (κ) value.
resultsInter-observer variability for the four and two classes of breast-composition assessment revealed moderate agreement (Fleiss' κ: first and second reading = 0.553 and 0.587, respectively) and substantial agreement (Fleiss' κ: first and second reading = 0.689 and 0.70, respectively). Intra-observer variability for the four and two classes of breast-composition assessment demonstrated substantial agreement (Cohen's κ, median = 0.758) and almost perfect agreement (Cohen's κ, median = 0.813). Assessments of consensus between the 10 physicians and the automated software Volpara® revealed slight agreement (Cohen's κ; first and second reading: 0.104 and 0.075, respectively).
conclusionsQualitative visual assessment of mammographic breast composition using the new Japanese classification revealed excellent intra-observer reproducibility. However, persistent inter-observer variability, presenting a challenge in establishing it as the gold standard in Japan.
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