Abstract
Evidence is accumulating on the use of digital mammography. But there is relatively little published guidance on how to manage hardcopy film-screen prior images in a soft-copy reporting environment. For a population screening program, one pressing question is 'to digitise priors, or not?'. The BreastScreen Victoria programme screens 200,000 women each year, with two-view mammography at 2-yearly intervals. Many women have completed their fifth round of screening. Ten million films are archived. Existing standards require independent double-blind reporting comparing prior and current images. As digital is introduced, each reader needs to compare soft-copy images with hard-copy priors. How do we merge the two different reading worlds, analogue and digital, or indeed should we even attempt this? Possibilities include digitising; using a special multi-viewer; using a dental viewing box; or loading an analogue multi-viewer alongside the soft-copy 5 MP monitors. Factors specific to digitising include the following: Is it possible to digitise in such numbers? Is it too time consuming or too expensive? What resolution should be used to digitise? Is the quality of digitised priors sufficient for comparative review? This poster traces the decision-making process to digitise prior images in the context of a digital mammography pilot within BreastScreen Victoria.
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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