Abstract
Efforts to reduce radiation dose should be linked to and limited by image quality and the radiation dose should only be lowered to levels compatible with image quality for adequate diagnosis; this is optimisation of mammography. Despite this link between image quality and mean glandular dose (MGD), the MGD is proposed only with regard to compression level achieved or population percentile, not image quality required/achieved.
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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