Complete internal audit of a mammography service in a reference institution for breast imaging

Abstract

ObjectiveUndertaking of a complete audit of the service of mammography, as recommended by BI-RADS®, in a private reference institution for breast cancer diagnosis in the city of São Paulo, SP, Brazil, and comparison of results with those recommended by the literature.Materials and MethodsRetrospective, analytical and cross-sectional study including 8,000 patients submitted to mammography in the period between April 2010 and March 2011, whose results were subjected to an internal audit. The patients were followed-up until December 2012. ResultsThe radiological classification of 7,249 screening mammograms, according to BI-RADS, was the following: category 0 (1.43%), 1 (7.82%), 2 (80.76%), 3 (8.35%), 4 (1.46%), 5 (0.15%) and 6 (0.03%). The breast cancer detection ratio was 4.8 cases per 1,000 mammograms. Ductal carcinoma in situ was found in 22.8% of cases. Positive predictive values for categories 3, 4 and 5 were 1.3%, 41.3% and 100%, respectively. In the present study, the sensitivity of the method was 97.1% and specificity, 97.4%.ConclusionThe complete internal audit of a service of mammography is essential to evaluate the quality of such service, which reflects on an early breast cancer detection and reduction of mortality rates.

Impact of the pink october in the mammographic screening adherence in a reference center in oncology

“…When compared to other studies [14][15][16] , the present study observed a greater proportion of mammograms classified as BI-RADS 3 and 4 and a similar number of BI-RADS 5 mammograms. Some factors may be considered to explain this result.…”

“…However, it is observed that results of different centers are not the same 16 . Thus, studies that use data from several services 14,16 may be subject to greater heterogeneity than those evaluating a single center 15 . Moreover, the different socioeconomic realities found in our country may contribute so that the screening is offered in an unequal way in different locations, influencing the rate of tumor detection 10,17 .…”

“…Nevertheless, the BI-RADS 5 category presented good agreement between studies. This classification offers rather typical findings with high positive predictive value 15 , while categories 3 and 4 may point toward some findings of lower predictive value. This could contribute to a higher interobservational agreement in tests categorized as BI-RADS 5 18 .…”

Breast Cancer Screening: Updated Recommendations of the Brazilian College of Radiology and Diagnostic Imaging, Brazilian Breast Disease Society, and Brazilian Federation of Gynecological and Obstetrical Associations

“…21 In addition, as previously mentioned, the incidence of breast cancer among women aged 40-50 years in Brazil and other developing countries is proportionally higher than that reported in developed countries. 3,5 Therefore, the CBR, SBM and FEBRASGO recommend that this group of women be included in breast cancer screening protocols in Brazil.…”

“…1,2 In Brazil, despite all efforts, an increase in both breast cancer incidence and mortality rates has been noticed. [3][4][5] One peculiarity of breast cancer in Brazil and in other developing countries is that its incidence among women aged 40-50 years is proportionally higher than that reported in developed countries. [6][7][8] Programs that aim at standardizing breast cancer screening guidelines -as well as educating the population regarding the importance of such tests -should be promoted.…”