Abstract
The expansion of the National Health Service Breast Screening Programme (NHSBSP) has increased workload, adding to existing pressure on resources due to a shortage of radiologists. As a result some units have introduced double reading by two radiographers, with arbitration by a radiologist or breast clinician. Although some experimental work has supported such a move, the Advisory Committee on Breast Cancer Screening has requested further evidence from a real-life setting to support this change in reading practice. An observational study was initiated in 2004. A questionnaire was developed to document annually the reading practices of all screening units, and number of years of experience of individual film readers. Information gathered from the questionnaires, together with routine data from the KC62s, will allow us to compare the performance of units using radiographer-only double reading with that of other units. We will also be able to compare the performance before and after the change in reading protocol for units moving to radiographer-only double reading. The main outcome measures of performance will be cancer detection rates, standardised detection ratios and recall rates.
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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