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This paper evaluates the contribution of dual reading to cancer detection rates in a non-specialized breast cancer screening programme in the Bouches-du-Rhn̂e district (France). All mammograms were read first by one of 120 field radiologists and secondly by one of six experts at the coordinating centre. All women with at least one positive reading were recalled. 2799 of the 77 236 women screened were recalled by the field radiologist and 1770 by the expert. The expert detected an additional 15% () of cancers. 49% of these tumours were smaller than 10 mm and 38% of grade 1. The marginal cost of dual reading was 4, 040 per additional cancer detected and 4. 6% of total programme costs. In our decentralized programme, dual reading allows for the detection of good prognosis cancers which are missed by an isolated reader. The effects of dual reading on screening quality greatly outweigh its costs.
Séradour et al. (Sun,) studied this question.