Performance of diagnostic centers in the classification of opportunistic screening mammograms from the Brazilian public health system (SUS)

Abstract

Objective To evaluate the performance of diagnostic centers in the classification of mammography reports from an opportunistic screening undertaken by the Brazilian public health system (SUS) in the municipality of Goiânia, GO, Brazil in 2010. Materials and Methods The present ecological study analyzed data reported to the Sistema de Informação do Controle do Câncer de Mama (SISMAMA) (Breast Cancer Management Information System) by diagnostic centers involved in the mammographic screening developed by the SUS. Based on the frequency of mammograms per BI-RADS® category and on the limits established for the present study, the authors have calculated the rate of conformity for each diagnostic center. Diagnostic centers with equal rates of conformity were considered as having equal performance. Results Fifteen diagnostic centers performed mammographic studies for SUS and reported 31,198 screening mammograms. The performance of the diagnostic centers concerning BI-RADS classification has demonstrated that none of them was in conformity for all categories, one center presented conformity in five categories, two centers, in four categories, three centers, in three categories, two centers, in two categories, four centers, in one category, and three centers with no conformity. Conclusion The results of the present study demonstrate unevenness in the diagnostic centers performance in the classification of mammograms reported to SISMAMA from the opportunistic screening undertaken by SUS.

Temporal changes in breast cancer screening coverage provided under the Brazilian National Health Service between 2008 and 2017

“…Despite the lack of population-based screening policy in Brazil [10–12], the disparity between access to screening within the public healthcare system, on which 70% of the Brazilian population relies, and access to screening within the private healthcare system is evident. The incidence of tumors diagnosed at advanced stages reflects this situation, since 36.9% of such cases occur in women consulting within the public healthcare network, while in the private sector this rate falls to 16.2% [13–15].…”

Evaluation of breast cancer screening indicators in the female population using the National Health System, Brazil, 2018-2019: a descriptive study

“…16 Studies using SISMAMA data for Brazil as a whole and for Goiânia (capital of the state of Goiás) for the year 2010, indicate a predominance of BI-RADS ® 1 and 2 results and a proportion of examinations with BI-RADS ® 0 results close to the upper limit mentioned in the literature, which is above the proportion estimated in our study for women. 8 , 19 In Brazil, a tendency can be seen in practice to replace mammography incidences and maneuvers with ultrasound, which could increase the occurrence of BI-RADS ® 0 in screening results. Although the SISMAMA data referred to examinations, they also referred to the SUS, and the comparison with the SISCAN data indicates that there is consistency, in part, between the results.…”

Evolution of mammographic image quality in the state of Rio de Janeiro

“…However, despite the nationwide reach of such an Ordinance, one has not observed a standardization of those initiatives in the different Brazilian states and cities. Besides the recent contribution of professionals affiliated to medical societies or working in health institutions, universities and research centers ( 5 , 10 - 17 , 26 ) , some studies attribute the improvements to the regulatory activity of the health surveillance agency ( 6 , 9 , 27 ) .…”

“…Recently, several studies were developed about imaging quality ( 10 , 11 ) , recommendations for breast cancer screening ( 12 ) , adherence to mammography ( 13 ) , new techniques related to breast cancer diagnosis ( 14 - 16 ) , as well as about the relevance of internal audits in mammography services as a tool to depict the service quality ( 17 ) .…”