Öz
Aim: To audit our mammography screening practice according to the American College of Radiology (ACR)
recommendations in the years 2017 and 2018.
Method: We documented and analyzed our breast imaging data collected between March 14th, 2017 and December
31st, 2018 and performed a medical audit related to our mammography screening practice. The results were evaluated
according to ACR BI-RADS recommendations and performance benchmarks.
Results: The total number of mammographic screening patients who had no personal history of breast cancer was 2413
in 2017 and 2018. Our PPV1, PPV2 and PPV3 values were 5.6%, 30.8%, 52.9% accordingly. The recall rate was 11%.
Outcomes for cancer detection rate, minimal cancer rate, early-stage cancer rate and lymph node negativity were 0.74%,
50%, 77% and 64% respectively.
Conclusion: The mammographic screening outcomes are in accordance with ACR performance benchmarks. Despite
a desired high early cancer detection rate, axillary lymph node negativity was found to be below the desired range of
75%. Medical auditing is important for a breast imaging unit to monitor the effectiveness of screening and diagnostic
procedures and presents as an effective feedback tool to improve the practice.
Anahtar Kelimeler
Medical audit mammography ultrasound automated breast ultrasound screening
Kaynakça
- 1. Acheson HWK. Medical Audit and General Practice. Vol. 1, Lancet. 1975. 511–513 p.
- 2. CJ. D. 2013 ACR BI-RADS Atlas: Breast Imaging Reporting and Data System, 5th edition. Am Coll Radiol. 2014;537–53.
- 3. A Sickles E. Quality Assurance: How to audit your own mammography practice. Vol. 30, Radiologic clinics of North America. 1992. 265–275 p.
- 4. Gürdemir B, Aribal E. Assessment of mammography quality in İstanbul. Diagnostic Interv Radiol. 2012; 18: 468-472. Crossref
- 5. Sickles EA, Miglioretti DL, Ballard-Barbash R, Geller BM, Leung JWT, Rosenberg RD, et al. Performance benchmarks for diagnostic mammography. Radiology. 2005 Jun;235(3):775–90.
- 6. Feig SA. Auditing and benchmarks in screening and diagnostic mammography. Radiol Clin North Am. 2007 Sep;45(5):791–800, vi.
- 7. Carney PA, Sickles EA, Monsees BS, Bassett LW, Brenner RJ, Feig SA, et al. Identifying minimally acceptable interpretive performance criteria for screening mammography. Radiology 2010 May; 255(2):354–61.
- 8. Giuliano AE, Connolly JL, Edge SB, Mittendorf EA, Rugo HS, Solin LJ, et al. Breast CancerMajor changes in the American Joint Committee on Cancer eighth edition cancer staging manual. CA Cancer J Clin. 2017 Jul;67(4):290–303.
- 9. Edge SB, Compton CC. The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Vol. 17, Annals of surgical oncology. United States; 2010. p. 1471–4.
- 10. Türk A, Aribal E. Medical audit of mammography screening examinations. Marmara Med J. 2002; 15: 27-31.
- 11. Tuncbilek I, Ozdemir A, Gultekin S, Ogur T, Erman R, Yuce C. Clinical outcome assessment in mammography: an audit of 7,506 screening and diagnostic mammography examinations. Diagn Interv Radiol. 2007 Dec;13(4):183–7.
- 12. Zackrisson S, Lang K, Rosso A, Johnson K, Dustler M, Fornvik D, et al. One-view breast tomosynthesis versus two-view mammography in the Malmo Breast Tomosynthesis Screening Trial (MBTST): a prospective, population-based, diagnostic accuracy study. Lancet Oncol. 2018 Nov;19(11):1493–503.
- 13. Skaane P, Sebuodegard S, Bandos AI, Gur D, Osteras BH, Gullien R, et al. Performance of breast cancer screening using digital breast tomosynthesis: results from the prospective populationbased Oslo Tomosynthesis Screening Trial. Breast Cancer Res Treat. 2018 Jun;169(3):489–96.
- 14. Gultekin M, Ozturk C, Ozturker Z, Boztaş G, Hatice Turan S, Dundar S, et al. Centralization of mammography reporting with mobile trucks: Turkish experience. Vol. 10, Preventive Medicine Reports. 2018.
- 15. Kayhan A, Gurdal SO, Ozaydin N, Cabioglu N, Ozturk E, Ozcinar B, et al. Successful first round results of a Turkish breast cancer screening program with mammography in Bahcesehir, Istanbul. Asian Pac J Cancer Prev. 2014;15(4):1693–7.
- 16. Aribal E, Mora P, Chaturvedi AK, Hertl K, Davidovic J, Salama DH, et al. Improvement of early detection of breast cancer through collaborative multi-country efforts: Observational clinical study. Eur J Radiol. 2019 Jun;115: 31–8.
Mamografi Tarama Sonuçlarının BI-RADS’a Göre Değerlendirilmesi; Bir Meme Görüntüleme Merkezinin Tıbbi Denetimi
Öz
Amaç: Kliniğimizde 2017 ve 2018 yıllarında yapılan tarama mamografilerinin sonuçlarının American College of Radiology
(ACR) önerileri doğrultusunda karşılaştırmalı olarak değerlendirmeyi amaçladık.
Yöntem: 14 Mart 2017 ve 31 Aralık 2018 tarihleri arasında yapılan tarama mamografi sonuçlarını kaydedip analiz ettik.
Bu analizleri kullanarak tarama mamografi uygulamalarımızı denetledik. Sonuçlar ACR BI-RADS önerileri ve performans
kriterlerine göre değerlendirildi.
Bulgular: Meme kanseri öyküsü bulunmayan kadınlara yapılan tarama mamografisi sayısı toplam 2413‘tü. Pozitif
Öngörü Değeri (PÖD)1, PÖD2 ve PÖD3 hesaplamalarımız sırasıyla %5,6, %30,8 ve %52,9 idi. Geri çağırma oranı ise %11’di.
Kanser saptama oranı, minimal kanser oranı, erken evre kanser oranı ve lenf nodu negatifliği çıktıları sırasıyla %0,74, %50,
%77 ve %64 olarak saptandı.
Sonuç: Tarama mamografilerinin değerlendirme çıktılarının ACR performans kriterleri ile uyumlu olduğu görüldü. Erken
evre meme kanseri saptama oranı istenildiği gibi yüksek olmasına rağmen aksiller lenf nodu negatiflik oranının istenilen
%75’lik oranın altında kaldığı görüldü. Medikal denetleme, meme görüntüleme biriminin tarama ve tanı çalışmalarının
etkinliğini gösterme ve birimin uygulamalarının iyileşmesi için etkili bir geri bildirim yöntemi olması açısından önemlidir.
Anahtar Kelimeler
Medikal denetleme mamografi ultrason otomatik meme ultrasonu tarama
Kaynakça
- 1. Acheson HWK. Medical Audit and General Practice. Vol. 1, Lancet. 1975. 511–513 p.
- 2. CJ. D. 2013 ACR BI-RADS Atlas: Breast Imaging Reporting and Data System, 5th edition. Am Coll Radiol. 2014;537–53.
- 3. A Sickles E. Quality Assurance: How to audit your own mammography practice. Vol. 30, Radiologic clinics of North America. 1992. 265–275 p.
- 4. Gürdemir B, Aribal E. Assessment of mammography quality in İstanbul. Diagnostic Interv Radiol. 2012; 18: 468-472. Crossref
- 5. Sickles EA, Miglioretti DL, Ballard-Barbash R, Geller BM, Leung JWT, Rosenberg RD, et al. Performance benchmarks for diagnostic mammography. Radiology. 2005 Jun;235(3):775–90.
- 6. Feig SA. Auditing and benchmarks in screening and diagnostic mammography. Radiol Clin North Am. 2007 Sep;45(5):791–800, vi.
- 7. Carney PA, Sickles EA, Monsees BS, Bassett LW, Brenner RJ, Feig SA, et al. Identifying minimally acceptable interpretive performance criteria for screening mammography. Radiology 2010 May; 255(2):354–61.
- 8. Giuliano AE, Connolly JL, Edge SB, Mittendorf EA, Rugo HS, Solin LJ, et al. Breast CancerMajor changes in the American Joint Committee on Cancer eighth edition cancer staging manual. CA Cancer J Clin. 2017 Jul;67(4):290–303.
- 9. Edge SB, Compton CC. The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Vol. 17, Annals of surgical oncology. United States; 2010. p. 1471–4.
- 10. Türk A, Aribal E. Medical audit of mammography screening examinations. Marmara Med J. 2002; 15: 27-31.
- 11. Tuncbilek I, Ozdemir A, Gultekin S, Ogur T, Erman R, Yuce C. Clinical outcome assessment in mammography: an audit of 7,506 screening and diagnostic mammography examinations. Diagn Interv Radiol. 2007 Dec;13(4):183–7.
- 12. Zackrisson S, Lang K, Rosso A, Johnson K, Dustler M, Fornvik D, et al. One-view breast tomosynthesis versus two-view mammography in the Malmo Breast Tomosynthesis Screening Trial (MBTST): a prospective, population-based, diagnostic accuracy study. Lancet Oncol. 2018 Nov;19(11):1493–503.
- 13. Skaane P, Sebuodegard S, Bandos AI, Gur D, Osteras BH, Gullien R, et al. Performance of breast cancer screening using digital breast tomosynthesis: results from the prospective populationbased Oslo Tomosynthesis Screening Trial. Breast Cancer Res Treat. 2018 Jun;169(3):489–96.
- 14. Gultekin M, Ozturk C, Ozturker Z, Boztaş G, Hatice Turan S, Dundar S, et al. Centralization of mammography reporting with mobile trucks: Turkish experience. Vol. 10, Preventive Medicine Reports. 2018.
- 15. Kayhan A, Gurdal SO, Ozaydin N, Cabioglu N, Ozturk E, Ozcinar B, et al. Successful first round results of a Turkish breast cancer screening program with mammography in Bahcesehir, Istanbul. Asian Pac J Cancer Prev. 2014;15(4):1693–7.
- 16. Aribal E, Mora P, Chaturvedi AK, Hertl K, Davidovic J, Salama DH, et al. Improvement of early detection of breast cancer through collaborative multi-country efforts: Observational clinical study. Eur J Radiol. 2019 Jun;115: 31–8.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 16 Aralık 2020 |
| Gönderilme Tarihi | 21 Ağustos 2019 |
| Yayımlandığı Sayı | Yıl 2021Cilt: 12 Sayı: 1 |
