Mammography is the method of choice for early detection of breast cancer. In Serbia, mammography is performed only clinically, although there is a plan to introduce mammography as a screening method. Currently, there are 60 mammographic units in practice, resulting in 70 000 mammographies annually. The survey was conducted in order to investigate mammographic practice in Serbia, identify weak points and suggest appropriate corrective measures. Basic technical parameters of the X-ray tube and generator, processing, image quality, and patient doses in 20 mammographic units were studied. The survey demonstrated considerable variations in technical parameters that affect image quality, and patients doses. Patient dose levels, in terms of the mean glandular dose, were fairly consistent with current European reference levels: 1.8 (0.40-4.3) mGy. However, due to inappropriate image receptors, image processing and viewing conditions and automatic exposure control adjustment, suboptimal image quality was a common finding. Simple improvements of the radiographic technique and maintenance procedure, along with the rigid implementation of the quality control procedure and training of the operating staff, would improve the performance levels of mammographic practice in Serbia, i. e. result in the production of high quality images with a reasonably low radiation risk to patients

Breast cancer is the most frequent malignant neoplasm affecting the female population. In order to reduce its morbidity and mortality rate, a mammography screening campaign has been established in both entities of Bosnia and Herzegovina. In this paper, a brief survey is given on the mammography screening practice in the Republic of Srpska. As an illustration, results of measurements of technical parameters, including mean glandular dose, for 31 mammography units are presented. Large fluctuations in dose among different measuring sites were found, unacceptable not only from the standpoint of mammography screening, but in clinical mammography as a whole. Subsequently, a series of quality control tests and corrective measures throughout the mammography imaging chain are proposed, in line with international guidelines and newly promulgated national legislation. Dose optimization and image quality improvement are the first and foremost goals to be achieved in order to setup a successful mammography screening program

In order to set up a successful mammography screening program in the Republic of Srpska, a Siemens Mammomat 1000 X-ray machine was selected for analysis as the said mammography system is widely used in clinical practice. The variations in tube parameters (specific air kerma, high-voltage accuracy and reproducibility, linearity between exposure and dose exposure time) were monitored over a five-year period, from 2008 to 2012. In addition, due to observed daily fluctuations for chosen parameters, a series of measurements were performed three times a day within a single-month period (mainly October 2012). The goal of such an experimental set up is to assess short-term and long-term stability of tube parameters in the given mammography unit and to make a comparison between them. The present paper shows how an early detection of significant parameter fluctuations can help eliminate irregularities and optimize the performance of mammography systems. [Projekat Ministarstva nauke Republike Srbije, br. 171007]