Keywords:
Breast, Mammography, Screening, Quality assurance
Authors:
V. Kääb-Sanyal1, N. M. Perry2, M. Broeders3, M. Rosselli Del Turco4, M. A. O. Thijssen5, R. Holland3; 1Berlin/DE, 2London/UK, 3Nijmegen/NL, 4Roma/IT, 5Arnhem/NL
DOI:
10.26044/ecr2019/C-2079
Aims and objectives
Germany is made up of 16 federal states with relevant legislation being the responsibility of the individual states,
including health care.
Nevertheless,
a centralized,
national breast screening programme was implemented in 2005-2009 according to the European Guidelines for Quality Assurance in Breast Cancer Screening and Diagnosis [1].
The programme covers mammography screening and full diagnostic assessment up to and including histological diagnosis.
95 screening units (SU),
each with one or more mammography units and one or more assessment units provide service to an eligible population of roughly 11 million women,
aged 50-69.
Within each SU,
one or two physicians (radiologists or gynaecologists),
the so-called responsible physicians (RP),
are in charge of the screening and assessment process as well as quality management.
The German programme has five Reference Centres (RC),
located in Berlin (RC Berlin),
Oldenburg (RC North),
Munster (RC Munster),
Marburg (RC Southwest),
and Munich (RC Munich),
see table 1 and figure 1.
Each RC has a designated screening expert as director and is responsible for training,
data collection,
evaluation and research.
The RCs also supervise the comprehensive quality management system that has been implemented within the German screening programme,
covering training of screening personnel,
equipment quality,
as well as internal and external quality control and management procedures,
see figure 2.
In addition,
each SU is certified before starting screening service and re-certified every 30 months by the German mammography screening office (Kooperationsgemeinschaft Mammographie - KoopG) together with the responsible RC.
Independent RC certification by EUREF (European Organisation for Quality Assured Breast Screening and Diagnostic Services) was instituted with the aim of facilitating successful delivery of the German programme.
|
Start |
Eligible population (total) |
Mammograms (year 2014) |
RC Munster |
07/2005 |
2,344,148 |
655,115 |
RC Munich |
10/2005 |
1,968,147 |
446,928 |
RC Berlin |
11/2005 |
1,961,354 |
592,637 |
RC North |
01/2006 |
1,713,751 |
468,550 |
RC Southwest |
04/2006 |
2,865,895 |
707,873 |
Table 1: Start date,
total eligible population,
and yearly number of mammograms (2014) performed in the assigned region of responsibility of the five RCs.