The role of consolidation and leadership by the national cancer screening program in symptomatic and asymptomatic radiological breast imaging optimisation and breast dose reduction in Ireland

Congress:

EuroSafe Imaging 2017

Poster Number:

ESI-0037

Type:

EuroSafe Imaging

Keywords:

Breast, Action 11 - Dialogue with industry, Action 3 - Image quality assessment based on clinical indications, Action 2 - Clinical diagnostic reference levels (DRLs), Action 5 - Exchange and collaboration with medical industry, Action 4 - Quality of radiological equipment, Action 3 - Optimisation, diagnostic reference levels, image quality, Mammography, Physics, Workforce

Authors:

G. Sugrue, P. Gilligan, R. Ennis, N. Phelan, M. Lewis, L. Rainford, F. Flanagan, E. R. Stanley, M. F. J. Ryan

DOI:

10.1594/esi2017/ESI-0037

DOI-Link:

https://dx.doi.org/10.1594/esi2017/ESI-0037

Fig. 1: Timeline showing the evolution of breast imaging in Ireland, culminating in the...

Fig. 2: Excerpt from the Irish Times, 1985, relating the discussion prior to the...

Fig. 4: Number of mammography machines per 1 000,000 inhabitants.

Fig. 5: The main contributors to Radiation protection in Ireland

Background/Introduction

Breast cancer is the most common cancer affecting European women today and is the one of the leading causes of cancer mortality[i]. The premise for breast cancer screening is early detection and earlier treatment[ii] and is founded on a large evidence base. The establishment of a breast cancer screening programme was the precursor to a wider Irish cancer screening programme[iii] including cervical and colorectal cancer screening. Mammography was first introduced into Ireland at the Mater Hospital in 1974 ( Fig. 1 , Fig. 2 )....

Description of activity and work performed

Action 3: Implement measures to maintain radiation doses within diagnostic reference levels (DRLs). “Diagnostic reference levels” refers to dose levels in medical radio-diagnostic practices for typical examinations for groups of standardized patients. The European Council Directive 2013/59[vii] has been unanimously adopted by the Council of the European Union in 2013. Each member state of the European Union is required by February 2018 to transpose the Directive into national legislation. This legislation, along with other professional and scientific guidance, emphasises the use of diagnostic reference levels...

Conclusion and Recommendations

Radiation safety plays a pivotal role in breast imaging since its inception as a separate discipline in 1974. Radiation protection systems have evolved in Ireland in tandem with optimisation of breast imaging quality and dose. A coherent strategy based on Eurosafe imaging principles is multifactorial. The consolidation of breast screening services to the eight major cancer centers has proved important in delivering excellence in breast imaging across a range of modalities. The national breast cancer screening service acts a flagship to deliver optimal services in...

Personal/Organisational information

G. Sugrue1, P. Gilligan2, R. Ennis3, N. Phelan4, M. Lewis5, L. Rainford6, F. Flanagan4, E. R. Stanley7, M. F. J. Ryan8; 1Department of Radiology, Mater Hospital Dublin /IE, 2Mater Private Hospital Dublin/IE, 3University Hospital Galway /IE, 4BreastCheck, Mater Hospital Dublin/IE 5Medical Exposure Radiation Unit, HSE Duplin/IE, 6 University College Dublin Dublin/IE 7Department of Radiology, Mater Hospital Dublin /IE 8Faculty of Radiology, Ireland and theUniversity College Cork Cork/IE

References

[i] Siegel, R. L., Miller, K. D. and Jemal, A. (2016), Cancer statistics, 2016. CA: A Cancer Journal for Clinicians, 66: 7–30. [ii] Bretthauer M, Kalager M. Principles, effectiveness and caveats in screening for cancer.Br J Surg.2013;100:55–65. doi: 10.1002/bjs.8995. [iii]National Irish Breast screening programme, Available from http://www.breastcheck.ie/ [iv] A O Doherty, Report on a clinical review of mammography service at Midland Regional Hospital Portlaoise, Health Service Executive, 2008. Available at http://www.lenus.ie/hse/handle/10147/45773 [v]IREFER Guidelines, Available at http://guidelines.irefer.org.uk/adult/#Tpc8 [vi] BreastCheck Programme Report 2014/15, Available at http://www.breastcheck.ie/content/annual_reports [vii]...