Abstract
The contribution of screening mammography to reducing mortality due to breast cancer in women over 40 years old has been clearly demonstrated. Nevertheless, film mammography has several technical limitations that diminish its performance in women with dense breasts. Digital mammography goes part of the way to overcoming these limitations, but its diagnostic accuracy can still be impaired by superposition of fibroglandular structures at different levels within the breast. It may be possible to improve sensitivity and specificity further by producing tomographic images of the breast through one of two new techniques, tomosynthesis or breast computed tomography. Tomosynthesis can be carried out on a modified digital mammography system in which the X-ray tube can be rotated about the breast to obtain a number of projection views over a range of different angles. The images are obtained from these projections by mathematical reconstruction. Computed tomography requires a dedicated gantry that allows a full rotation of the X-ray beam about the pendant breast as the woman lies prone on a table. Each of these imaging methods isolates structures within the breast, potentially making tumours and microcalcifications more conspicuous. Each technique has its strengths and weaknesses with respect to radiation dose and various aspects of image quality, and these will be discussed in the current presentation. In addition, trials underway to evaluate the techniques' performance will be described.
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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