Abstract

In The Netherlands a number of (screening) trials with digital mammography have started. The first trial began in 1999, in which the applicability of digital mammography was tested in a clinical environment. For this purpose a GE Senographe 2000D was installed in the Radboud University Nijmegen Medical Centre. The outcome of this trial was positive. Therefore in 2002 a second trial started at a static screening site in Utrecht with a Lorad Selenia system. In this trial, digital mammography was evaluated in a screening environment with its specific demands regarding workflow. In 2004 two more trials were started with mobile digital screening units. In these trials, a Fuji FCR Profect and an Agfa DM 1000 system were installed in the screening units. This summer a new trial will start at a static screening unit in Nijmegen in which digital mammography equipment from different vendors (General Electric, IMS, Sectra, Planmed) will be installed to test connectivity. Results of all trials will be presented with emphasis on physical and technical aspects and workflow issues. Problems with the mammography systems in the trials will be discussed. Besides this, some experiences with digital mammography equipment in Dutch hospitals will be discussed with emphasis on possible pitfalls.

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

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Summary

Introduction

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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