NATURE OF EXPERTISE IN SEARCHING MAMMOGRAMS FOR BREAST MASSES

Rationale and Objectives. The authors investigated how training and ex perience affect the performance of observers searching mammograms for breast masses. Methods. Eye positions of mammographers, mammography te chnologists, mammography residents, and laypersons were compared to sc an paths generated by a simulated scanner as each searched nine two-vi ew digital mammogram pairs for breast masses. Results. Analysis of tim e-to-hit data revealed that mammographers and mammography technologist s with the most extensive training and experience had the fastest sear ch times in the detection and confirmation of a breast mass on two vie ws. Scanning patterns of less-experienced mammography residents were l ess efficient due to wider dispersion of visual attention between pote ntial breast masses and perturbations in breast parenchyma. Because la ypersons lacked both training and experience in mammography, bright bl obs in the breast image were considered to be intuitively valid target candidates and these features distracted the search by capturing visu al attention. Conclusion. Experience reading normal and abnormal mammo grams plays a critical role in training radiologists. Experience combi ned with training provides the basis for generating efficient visual s earch strategies and developing distinctive conceptual criteria for pe rceptual differentiation and interpretation of true breast masses from image artifacts and structured noise that mimics breast abnormalities .