Abstract
Guernsey provides healthcare for a population of 60,000. An on-island breast screening programme has existed since March 1995, with a 2-year screening round. Data have been analysed for six screening rounds to the end of March 2007, and have been evaluated against the National Health Service Breast Screening Programme (NHSBSP) Pritchard Standards. The small cohort size (<4,000 per annum) necessitates off-island screen reading by NHSBSP readers. Assessments are performed in Guernsey by a single breast radiologist. The majority of breast surgery is performed in Guernsey. Over the six screening rounds, a total of 39,166 screening mammograms have been performed, 2,542 assessment visits have been made, and 208 cancers have been identified (149 invasive, 59 ductal carcinoma in situ). Examples of standards evaluated for the six rounds: compliance, >90%; standardised detection rate, range 0.6 to 1.83; small cancer detection rates, 2.46/10,000 (average); interval cancers, 1.22 per 1,000 screened (average); 10-year survival from screen-detected cancers, 92%. These data show an effective screening programme assessed by Pritchard Standards, and demonstrate a model for the delivery of breast screening in a small isolated population.
Highlights
Breast-sparing oncoplastic procedures (BSOP) offer a predictive marker guiding use of anti-oestrogen therapy, and radical new alternative to mastectomy and conventional breast- expression profiling appears to select patients more or less likely to conserving surgery in early breast cancer treatment
The aim was to document attitudes to male radiographers and the effect on the programme performance parameters through a postal questionnaire completed by 85.8% of a random sample of 2,000 women recently screened by BreastCheck
Nine per cent would not have proceeded if the radiographer was male; 17.5% agreed that ‘If there were male radiographers I would not return for another screening appointment’; and 18.3% were unsure
Summary
Breast-sparing oncoplastic procedures (BSOP) offer a predictive marker guiding use of anti-oestrogen therapy, and radical new alternative to mastectomy and conventional breast- expression profiling appears to select patients more or less likely to conserving surgery in early breast cancer treatment. We have compared the results of screening with analogue and digital technology over our first 2 years, in terms of recall rates, cancer detection rates and positive predictive value, and found no overall significant difference in any of these parameters. Abnormalities are graded as A, B or C at consensus by the radiologists and reporting radiographers depending upon the mammographic likelihood of cancer and biopsy This means that patients can be allocated to one of our three assessment clinics and at specific times within those clinics to facilitate workflow. Methods A retrospective analysis of all breast cancer patients with recurrence who had completed 5 years of follow-up was performed. Infection control is not routinely included in the quality assurance process of all units
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