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Keywords:
Breast, Mammography, Screening, Quality assurance
Authors:
R. Gullien, J.-G. Andersen, A. E. Haakull, L. Sandvik, P. Skaane; Oslo/NO
DOI:
10.1594/ecr2016/C-0673
Aims and objectives
Breast cancer is one of the most common cancers in women worldwide with 1.7 million new incidents every year and 3.300 new cases every year in Norway.
Early detection and reliable diagnosis have proven to be the key to survival,
but imaging results can be unclear (1).
To decrease the breast cancer mortality,
the Norwegian Breast Cancer Screening Program (NBCSP) has been implemented.
This population-based program invites women aged 50-69 years biannually for a two-view (cranio-caudal,
CC,
and mediolateral-oblique,
MLO) mammography.
A widely used tool within Europe for quality evaluation and classifying mammograms is the PGMI classification system.
PGMI are not a diagnostic classification tool,
but a quality evaluation of each the mammograms with reference to a gold standard.
The PGMI is an acronym,
where P = perfect image,
G = good image,
M = moderately good images and I = inadequate images.
Dedicated radiographers at our hospital perform the PGMI classification of the screening images.
The purpose of the PGMI assessment is to monitor,
achieve and maintain high-quality mammography images.
Interval cancers (IC) are diagnosed in the time between two screening examinations,
after a normal/negative screening mammogram and before the next invitation.
We refer to baseline screening images as those carried out prior to the diagnosis of an IC.
Previous studies of screening mammograms have shown that the MLO images have potentials for improvements.
We therefore decided to evaluate the MLO screening images (2,
3).
The radiological assessment of mammograms might be challenge.
Despite independent interpretation/double reading with consensus meetings before a final management decision,
some cancers might be overlooked (3,
4).
The aim of this study is to compare the radiologist’s assessment of baseline screening mammograms prior to the interval cancer diagnose with the PGMI classification score of the MLO mammograms.