Breast cancer mammographic diagnosis performance in a public health institution: a retrospective cohort study

Breast cancer mammographic diagnosis performance in a public health institution: a retrospective cohort study

Objectives To evaluate the quality assurance of mammography results at a reference institution for the diagnosis and treatment of breast cancer in southern Brazil, based on the BIRADS (Breast Imaging Reporting and Data System) 5th edition recommendations for auditing purposes. Materials and methods...

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Bibliographic Details
Published in:Insights into imaging Vol. 8; no. 6; pp. 581 - 588
Main Authors: Mello, Juliana M.R.B., Bittelbrunn, Fernando P., Rockenbach, Marcio A. B. C., May, Guilherme G., Vedolin, Leonardo M., Kruger, Marilia S., Soldatelli, Matheus D., Zwetsch, Guilherme, de Miranda, Gabriel T. F., Teixeira, Saone I. P., Arruda, Bruna S.
Format: Journal Article
Language:English
Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-12-2017
Springer Nature B.V
SpringerOpen
Subjects:
Breast cancer
Cancer
Cohort analysis
Colleges & universities
Confidence intervals
Diagnosis
Diagnostic Radiology
Imaging
Internal Medicine
Interventional Radiology
Mammography
Mammography auditing
Medical diagnosis
Medicine
Medicine & Public Health
Neuroradiology
Original
Original Article
Public health
Quality assurance
Quality control
Radiology
Sensitivity
SISMAMA
Ultrasound
Mammography auditing
SISMAMA
Quality assurance
Breast cancer
Public health
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Summary:Objectives To evaluate the quality assurance of mammography results at a reference institution for the diagnosis and treatment of breast cancer in southern Brazil, based on the BIRADS (Breast Imaging Reporting and Data System) 5th edition recommendations for auditing purposes. Materials and methods Retrospective cohort and cross-sectional study with 4502 patients (9668 mammographies)) who underwent at least one or both breast mammographies throughout 2013 at a regional public hospital, linked to a federal public university. The results were followed until 31 December 2014, including true positives (TPs), true negatives (TNs), false positives (FPs), false negatives (FNs), positive predictive values (PPVs), negative predictive value (NPV), sensitivity and specificity, with a confidence interval of 95%. Results The study showed high quality assurance, particularly regarding sensitivity (90.22%) and specificity (92.31%). The overall positive predictive value (PPV) was 65.35%, and the negative predictive value (NPV) was 98.32%. The abnormal interpretation rate (recall rate) was 12.26%. Conclusions The results are appropriate when compared to the values proposed by the BIRADS 5th edition. Additionally, the study provided self-reflection considering our radiological practice, which is essential for improvements and collaboration regarding breast cancer detection. It may stimulate better radiological practice performance and continuing education, despite possible infrastructure and facility limitations. Main Messages • Accurate quality performance rates are possible despite financial and governmental limitations. • Low-income institutions should develop standardised teamwork to improve radiological practice. • Regular mammography audits may help to increase the quality of public health systems.
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ISSN:1869-4101
1869-4101
DOI:10.1007/s13244-017-0573-2