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Abstract
Background Breast cancer constitutes 21% of all cancer cases and ranks third according to cancer type in Kenya. Mammography therefore remains a powerful radiographic imaging technique for detecting and managing breast cancer. However, the active and radiosensitive glandular tissue calls for the need of an effective quality assurance program. Materials and Methods A questionnaire method was developed and used in recording the displayed patient dose, compressed breast thickness and exposure factors. The average glandular dose, device performance, and film quality grading were also carried out. Results There were 3264 films taken from 1252 women between 25 to 90 years old. The AGD per film was 2.14 (range 0.27-9.43) mGy for the cranio-caudal (CC) projection and 2.44 (range 0.20-10.12) mGy for the medio-lateral oblique (MLO) projection. In this study 17% of CC and 30% of MLO films recorded doses above the 3 mGy American College of Radiology using grid diagnostic reference level. Conclusion In view of the diagnostic dose finding of this study, the variation of mammography imaging techniques revealed the need for imaging guidelines, quality assurance and optimization of mammography practice in Kenya.
Highlights
The automated breast volume scanner (ABVS) is the first of its kind and utilises a large, 17 cm × 15 cm high-frequency ultrasound probe which sweeps across the whole breast generating images that can be reformatted into multiple planes and a 3D volume
A study of symptomatic breast units geographically spread over Ireland collected image quality, compression and radiation dose data from 18 mammography units; so how do these optimisation parameters compare nationally and internationally? The mean glandular dose (MGD) diagnostic reference level was proposed for the all-digital breast screening service [1] but not for the symptomatic breast service
MGDs received by symptomatic breast patients within Ireland are higher than those received in the all-digital Irish Breast Screening service, the differences for fullfield digital mammography (FFDM) are not substantial; 55 to 65 mm breast: 1.75 mGy versus 2.4 mGy at the 95th percentile
Summary
The automated breast volume scanner (ABVS) is the first of its kind and utilises a large, 17 cm × 15 cm high-frequency ultrasound probe which sweeps across the whole breast generating images that can be reformatted into multiple planes and a 3D volume. The aim of this study is to assess whether FFDM detects more disease than analogue mammography in patients with screen-detected cancer with pathological correlation. This study aims to analyse a large screening dataset to establish positive predictive values (PPVs) for malignancy on excision biopsy, for different classifications of B3 and for B4 NCBs. Objective critique of mammographic image quality (IQ) is vital to assess efficacy of services provided by mammography units. 30% of screen-detected DCIS diagnosed by 14G core biopsy will be upgraded to invasive carcinoma at definitive surgery, necessitating subsequent sentinel node procedure to complete staging This could be decreased by first-line large-bore vacuum-assisted biopsy. Routine MRI in the assessment of lobular carcinoma, invasive ductal carcinoma in dense breasts, patients younger than 35 or radioclinical discordance at the time of cancer diagnosis was introduced in the symptomatic breast unit of Ealing Hospital in 2009. False positive and negative rates for US axilla are discussed with analysis of tumour subgroups and pattern of positive nodes
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