Abstract
There is general acceptance that digital mammography screening will eventually replace the current analogue systems. Before this technology is introduced more widely for breast screening, however, assurances need to be made that it can improve or at least equal, the existing system in both quality and performance [1]. It is not simply a matter of replacing the existing mammography sets with digital systems. The Advisory Committee on Breast Cancer Screening supported setting up a multiprofessional Digital Steering Group to bring together the relevant expertise in breast screening and digital systems. The aim of the group was to identify areas of work required to be undertaken prior to implementation of digital systems in the screening service. The group had representation from England, Wales, Scotland and the private sector. Six areas of work were identified: technical parameters, clinical parameters, information issues, purchasing, training, and screening on mobiles. The Digital Steering Group of the National Health Service Breast Screening Programme (NHSBSP) has concluded that all the direct digital mammography systems tested by the NHSBSP meet the image quality and dose standards in the European Guidelines for Digital Mammography [2]. Only one of the computed radiography systems tested by the NHSBSP meets these standards. However, testing and evaluation of the new designs is ongoing.
Highlights
Axillary lymph node dissection has been standard practice for staging invasive breast cancer
Best estimates for where to credit this dramatic drop in death rate place approximately 50% of the credit with improved adjuvant chemotherapy and 50% with mammography
Full field digital mammography (FFDM) had a higher detection rate for ductal carcinoma in situ (DCIS) but no difference was observed for invasive tumours
Summary
Axillary lymph node dissection has been standard practice for staging invasive breast cancer. Aim To assess the feasibility of surgeons performing breast US in symptomatic breast clinics either as an adjunct to triple assessment or on their own for diagnostic and therapeutic purposes. The performance of individual units is monitored to ensure all women have access to an excellent service Aim This project aims to demonstrate how the Liverpool Breast Unit addressed failure to meet the national quality standard for the benign. Method A retrospective review of the records of patients who had undergone benign biopsy (2001–2002) was conducted to establish reasons for surgical referral and suggest corrective measures to enable the unit to meet the standard in the future. Columnar cell change (CCC) is diagnosed on core biopsies performed for indeterminate microcalcification. Method Mammograms of 33 cases with established CCC on core biopsy were reviewed and the radiological features, follow-up imaging and surgical excision histology (if performed) were collated. The results were completed when all units were undergoing assimilation onto the new banding procedures
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