Evaluation of the impact of a third mammographic reading in the French population-based breast cancer…

Cohort studyCancer epidemiology· Jul 2026

Evaluation of the impact of a third mammographic reading in the French population-based breast cancer screening program.

Akoï Koïvogui, Samira Saifi, Malala Razafija … Nicolas Sellier

Public Health & General Preventive MedicineCohort studyClinical practiceQ2IF 3.1

Third-reading reclassification to negative was linked to higher interval cancer risk

Evaluation of the impact of a third mammographic reading in the French population-based breast cancer screening program.

Akoï Koïvogui … Nicolas Sellier

Cancer epidemiology · Jul 2026

Background

The population-based breast cancer screening program (PBCSP) in France relies on a systematic second reading (Read-2) of mammograms initially interpreted as normal or benign at the first reading (Read-1).

Purpose

This study evaluates its impact in terms of the incidence of interval cancers.

Methods

The retrospective cohort study includes 1328,597 index mammograms (MT 0 ) classified as negative in Read-1 and reviewed in Read-2.

n = 426,603 women

Results

reclassifying to negative more than doubled interval cancer risk

HR 2.10 (95% CI 1.20 to 3.80)

null 1

1.20

3.80

CI excludes the null - significant

More results

Confirmation of positivity by Read-3 was more likely when the radiological abnormality (Architectural-distortion, Focal-asymmetry, Microcalcifications, Round-mass, Spiculated-mass) was seen in Read-3, regardless of the assessment made in Read-2.

Read-3 avoided more than 6000 ultrasounds, 700 biopsies, and nearly 7600 additional mammograms.

“

Conclusion · 1 of 2

While it reduces the overuse of exams, Read-3 was associated with a higher interval cancer risk.

Conclusion · 2 of 2

These results underline the interest of a national reflection on the place of a targeted Read-3 with a security reference framework, or even its replacement by AI-based decision-making tools.

Evaluation of the impact of a third mammographic reading in the French population-based breast cancer screening program.

Evaluation of the impact of a third mammographic reading in the French population-based breast cancer screening program.

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