The significance of mammographic quality control for assessing the quality of diagnostic mammographic reporting system

Abstract

Objective To investigate the significance of the objective audit system of mammography diagnostic report in evaluating the diagnostic mammography practice in Peking University First Hospital. Methods According to the regulations issued by the US Food and Drug Administration (FDA 1992) and the mammographic practice parameters recommended by the American College of Radiology (ACR 2013), we retrospectively analyzed the diagnostic mammographic reports in Peking University First Hospital from November 14, 2015 to November 14, 2016. We calculated the diagnostic sensitivity, specificity, positive predictive value (PPV2), and the third positive predictive value (PPV3). The pathological and follow-up results(the negative patient)were used as the golden standard. All data were compared with the reference data of United States mammography diagnostic report system. Results A total of 1 779 mammography diagnostic reports were analyzed, including 137 malignant cases and 1 642 benign cases. The sensitivity of diagnosis of malignant breast lesions was 93.4% (128/137), the specificity was 95.2% (1 563/1 642), PPV2 was 61.8% (128/207) and PPV3 was 83.1%(128/154). Compared with the recommended target value (sensitivity>85.0%, specificity>90.0%, PPV2: 25.0%~40.0%), most statistical data were within the recommended range except PPV2 and PPV3, which werehigher. Conclusions The quality of the mammographic report in Peking University First Hospital reached the recommended level in the United States. However, the low proportion of recommendation of biopsy suggested a possibility of missed diagnosis. Key words: Breast neoplasm; Mammography; Quality of diagnostic report