Purpose: Mean Glandular Dose (MGD) is the quantity related to the risk of radiation-induced breast cancer. This study aimed to evaluate the MGD in screening mammography for women with breast implants. Methods: This retrospective study used data of 2680 mammographies of 335 asymptomatic women with mammary implants examined in a digital direct x-ray unit. Each woman had a total of eight images: four in standard views and four with posterior displacement of the implant (ID). Data on kV, mAs, target/filter combination, compressed breast thickness and MGD were obtained from the DICOM header of the stored images. Quantitative variables were presented through descriptive statistics for median (5th–95th percentiles); and the qualitative variables were presented by numbers and percentages. Mean glandular doses of standard views and ID views were compared and statistical analysis was used to assess the influence of implant position, breast glandularity and thickness on mean glandular doses. Results: Median MGD for standard views were 3.30 (2.60–4.00) mGy for CC and 3.31 (2.70–4.20) mGy for MLO. For ID views, median were 1.20 (0.90–2.20) mGy and 1.40 (0.97–3.74) mGy for CC and MLO views, respectively. Median MGD for the whole examination of women with breast implants was 9.60 (7.92–12.07) mGy, ranging from 6.25 to 21.50 mGy. When comparing MGD median for standard and ID views it was found a statistically significant difference (p < 0.05), with higher doses for the standard views due to the greater compressed breast thickness in these views. It was observed that, in the standard views, MGD decreases with increasing breast thickness due to the manual radiographic techniques used to expose the women. It was also observed that implant position does not affect MGD in breast augmentation mammography. Conclusion: Mammography of women with mammary implants gives higher radiation doses when compared with those without implants. For more accurate dose assessment in augmented breast mammography, it is necessary that specific conversion factors for the calculation of MGD based on air kerma at entrance of breasts with implants are made available.

Introduction: Mammography screening has been the best method for detecting early tumors and reducing breast cancer mortality according to different studies. In Brazil, the number of women who undergo mammography tests by the Brazilian Unified Health System (SUS) has been far below international recommendations. Objective: To describe the number of mammographies, mammography coverage, and the amount spent on this exam during 2019 by SUS, in Brazil. Method: Ecological study with data from the Department of Informatics of the Brazilian Unified Health System and the Brazilian Institute for Geography and Statistics in order to verify the number of mammographies performed by the SUS concerning the Brazilian female population in Brazil, in the age group of 50 to 69 years, in the states and in macro-regions during 2019. Results: In 2019, 2,660,469 mammographies were performed in the country out of the expected total of 12,154,979, accounting for a 21.9% mammography coverage by SUS at the cost of BRL 117,841,231.97. The lowest coverage rates were verified in the states of Amapá (0.6%) and the Federal District (4.9%), whereas the best rates were found in the states of Paraná (29.7%) and Alagoas (29.6%). Conclusions: The number of mammographies performed in Brazil in 2019 by SUS corresponded to almost ¼ of the country’s need, with mammography coverage far below the target and being widely different among the many Brazilian states

Objective: To evaluate the clinical quality of mammograms performed in users of the Unified Health System (SUS), referred to a tertiary hospital. Methods: A prospective study whose unit of observation was the mammograms of women referred for consultation in a Breast Cancer Resource Center, located in the city of Goiânia, Brazil, from May to October 2017. Mammograms for screening or for diagnosis were included, performed within six months prior to study inclusion. The clinical quality of the mammograms was evaluated using 40 variables per exam, related to the identification, the technique of the exam, the executing equipment, the radiological findings, the exam report and the mammary positioning. For these last variables, a comparison was made according to the origin of the exam (public vs. private network). Results: A total of 4560 items of clinical image quality were evaluated in 114 women whose mean age was 50.6 years. Of the total items analysed, there were 660 failures (14.47%), and 443 (67.12%) failures were related to breast positioning. Among the positioning failures, the absence of visualization of the pectoralis major muscle (86.8%) and the inframammary sulcus (79.8%) in the CC and MLO incidences, respectively, were the most frequent. Considering the positioning criteria evaluated in the MLO incidence, the examinations performed in the private network presented a higher risk of failures related to the nipple centered (RR 4.66, 95%CI 1.05-20.62, p=0.02) and the visualization of the retro-mammary fat (RR 4.14; 95%CI 0.92-18.66, p=0.04), in relation to the exams performed in the public network. Conclusion: The mammograms analysed presented an inadequate quality pattern, with predominance of non-compliance related to breast positioning.

INTRODUCTION: In Brazil, access to mammography is provided through the National Health System (SUS), the Supplemental Health System, or is paid for directly by the patient. SUS is the official government system and was established to conform to the constitutional requirement that health is a right of all Brazilian citizens and a duty of the state. In recent years SUS breast cancer control policies have advanced and government strategies for early detection have strengthened. However, evaluations are needed to monitor the effectiveness of these actions. OBJECTIVE: To describe the coverage of mammography in breast cancer screening conducted by the National Health System in Brazilian macro-regions and states in 2012. METHODS: An ecological study, where the estimate of coverage was the number of exams performed expressed as a percentage of the number of exams expected in the target population of women 50-69 years old. The exams performed refer to target population mammography production data from the Outpatient Information System (CIS) of DATASUS. To calculate the expected number of exams for this population, the biennial screening recommendations of the National Cancer Institute (NCI) and an estimate of the female population based on the census of the Brazilian Institute of Geography and Statistics (IBGE) were used. RESULTS: The coverage estimate for SUS-performed mammography in Brazil in 2012 was 26.6%. Stratified by macro region, the lowest coverage was in the northern region (12.1%) and highest in the South (34.6%). National coverage of screening mammography in Brazil, performed by the National Health System (SUS), according to the geographical regions.Macro-regionsCoverageMinimumMaximump*North Region12.10.227.2Northeast Region23.910.337.20.001Southeast Region28.515.532.5South Region34.630.341.0Midwest Region14.810.319.7* Chi-square test Units of the Federation an estimated coverage ranged from 0.2% to 41%, the lowest in the state of Amapa and the largest in Santa Catarina. 48% of states were in the range of 10.1% to 20% coverage. CONCLUSION: The results imply that the contribution of SUS to mammography screening in Brazil is higher in both macro-regions and states with higher income and better organised health system. Citation Format: Ruffo Freitas-Junior, Danielle CN Rodrigues, Rosangela S Correa, João-Emilio Peixoto, Rosemar MS Rahal. The contribution of the national health system to mammographic screening in Brazil [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P3-02-04.

Background: The largest radiological accident to occur in any urban area happened in a Brazilian state capital city in 1987 to the detriment of the population and the environment. One major concern regarding deleterious effects in the population was a possible increase in breast cancer incidence rates, since the literature shows that exposure of an individual to ionizing radiation is one of the risk factors for cancer. This study analyzed trends in the incidence of breast cancer over the 25-year period following the radiological accident. Methods: This ecological, population-based study was conducted to determine the incidence of breast cancer in female residents of Goiânia, Goiás, Brazil, between 1988 and 2012. The data were collected from the Goiânia population-based cancer registry. Crude and age-standardized incidence rates were calculated. The Joinpoint software program was used to calculate annual percent changes (APC) in the incidence of breast cancer. Results: Overall, 7,365 new cases of breast cancer were identified, with an annual crude incidence rate of 23.09/100,000 women in 1988 and of 71.65/100,000 women in 2012. The age-standardized incidence rate was 35.63/100,000 women in 1988 and 65.63/100,000 women in 2012. Analysis of the APC showed a significant annual increase of 4.8% in the incidence between 1988 and 2005 (p&lt;0.0001) followed by stabilization in 2005-2012, with an APC of -3.5% (p=0.1). Conclusion: There was an increase in the incidence of breast cancer in the female residents of Goiânia, Goiás in the first 17 years of evaluation (1988-2004) followed by a period of stabilization until 2012. Keywords: breast cancer; epidemiology; incidence; age group; Goiânia; Brazil. Table 1. Annual percent change in the age-standardized incidence rate of female breast cancer by age in the city of Goiânia, Goiás, Brazil between 1988 and 2012.Age Group (years)Trend 1 (Years)APC^*(95%CI)pTrend 2 (Years)APC ^*(95%CI)p≤391988-20075.53.9 - 7.20.0012007-2012-7.0-15.3 - 20.140 - 491988-20054.63.6 - 5.60.00012005-2012-3.7-6.5 - -0.80.000150 - 691988-20046.34.6 - 80.00012004-2012-3.4-6.5 - -0.30.0001≥701988-20120.9-0.1 – 1.90.1–---^Significance: p &gt;0.05; * Annual percent change (APC); * Coefficient of the incidence per 100,000 women; CI: Confidence interval. Citation Format: Marina E Rocha, Rosemar MS Rahal, Ruffo Freitas-Junior, Rosangela S Correa, Danielle CN Rodrigues, Edesio Martins, Leonardo R Soares, Jose C Oliveira. Trends in the incidence of breast cancer following the radiological accident in Goiânia, Brazil: A 25-year analysis [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-08-14.