J Korean Soc Radiol.  2019 May;80(3):513-523. 10.3348/jksr.2019.80.3.513.

Medical Audit of Screening Mammography at a Tertiary Referral Hospital Using the 5th Edition of Breast Imaging Reporting and Data System

• Byon JH
• Kim MJ
• Park VY
• Yoon JH
• Moon HJ
• Kim EK

• KMID: 2454030
• DOI: http://doi.org/10.3348/jksr.2019.80.3.513

Abstract

PURPOSE
The purpose of this study is to analyze medical audit of screening digital mammography at a tertiary hospital and to review changes of medical audit according to newly revised standard.
MATERIALS AND METHODS
We analyzed 7764 asymptomatic women who underwent screening mammogram at our hospital from January, 2013 to December, 2014. The family or past history of breast, gynecologic and other cancers was reviewed retrospectively. Analysis 1 defined category 3 as positive result and analysis 2 defined category 3 as negative.
RESULTS
The overall cancer detection rate was 4.6 per 1000 cases. The cancer detection rate in patients with non-gynecological and non-thyroid cancer (n = 391, 51.2) was the highest compared to patients with family history of breast cancer (n = 691, 1.4), or gynecological cancer (n = 311, 12.9). In analysis 1, positive predictive value 1 decreased 1.3% (6.0% vs. 7.3%) and recall rate increased 1.3% (7.3% vs. 6.0%) compared with analysis 2. The results were appropriate for newly revised target.
CONCLUSION
The results of screening digital mammography in the tertiary medical institution showed excellent results even if category 3 was regarded as positive. In addition, screening tests for secondary cancer are needed in the tertiary hospital.

MeSH Terms

Breast Neoplasms
Breast*
Female
Humans
Information Systems*
Mammography*
Mass Screening*
Medical Audit*
Retrospective Studies
Tertiary Care Centers*

Reference

1. Andersson I, Aspegren K, Janzon L, Landberg T, Lindholm K, Linell F, et al. Mammographic screening and mortality from breast cancer: the Malmö mammographic screening trial. BMJ. 1988; 297:943–948.

2. Bjurstam N, Björneld L, Duffy SW, Smith TC, Cahlin E, Eriksson O, et al. The Gothenburg breast screening trial: first results on mortality, incidence, and mode of detection for women ages 39-49 years at randomization. Cancer. 1997; 80:2091–2099.

3. Cho BR. Evaluation of the validity of current national health screening program and plan to improve the system. Cheongju: Korea Centers for Disease Control and Prevention;2013.

4. Frisell J, Lidbrink E, Hellström L, Rutqvist LE. Followup after 11 years—update of mortality results in the Stockholm mammographic screening trial. Breast Cancer Res Treat. 1997; 45:263–270.

5. Habbema JD, Van Oortmarssen GJ, Van Putten DJ, Lubbe JT, Van der Maas PJ. Age-specific reduction in breast cancer mortality by screening: an analysis of the results of the Health Insurance Plan of Greater New York study. J Natl Cancer Inst. 1986; 77:317–320.

6. Miller AB, Wall C, Baines CJ, Sun P, To T, Narod SA. Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial. BMJ. 2014; 348:g366.

7. Moss SM, Cuckle H, Evans A, Johns L, Waller M, Bobrow L. Effect of mammographic screening from age 40 years on breast cancer mortality at 10 years’ follow-up: a randomised controlled trial. Lancet. 2006; 368:2053–2060.

8. Tabár L, Vitak B, Chen TH, Yen AM, Cohen A, Tot T, et al. Swedish two-county trial: impact of mammographic screening on breast cancer mortality during 3 decades. Radiology. 2011; 260:658–663.

9. Sprague BL, Arao RF, Miglioretti DL, Henderson LM, Buist DS, Onega T, et al. National performance benchmarks for modern diagnostic digital mammography: update from the Breast Cancer Surveillance Consortium. Radiology. 2017; 283:59–69.

10. Choi N, Lee A, Lee HK, Yi BH, Cha JG. Mammogrphic screening provided by the National Health Insurance Corporation: a 1 year audit in a secondary medical institution. J Korean Soc Radiol. 2009; 60:51–55.

11. Kang BJ, Lee WC, Lee JH, Kim HS, Cha ES, Choi JJ, et al. Medical audit of screening mammography performed in women over 40 years old at seven affiliated university hospitals for one year. J Korean Soc Breast Screen. 2008; 5:14–20.

12. Kim JY, Han BK, Choe YH, Kim JH. Screening mammogram in health center: medical audit for six years. J Korean Radiol Soc. 2003; 49:137–142.

13. Kim MH, Lee MJ, Oh KK, Lee KS. Screening mammography in a health promotion center for 5 years: results of medical audits. J Korean Radiol Soc. 2000; 42:859–864.

14. Choi HK, Park JM, Lee JH, Son BH, Ahn SH. Screening mammography: the results for four years. J Korean Radiol Soc. 2000; 42:1003–1008.

15. Sickles EA, D'Orsi CJ, D'Orsi CJ. ACR BI-RADS® follow-up and outcome monitoring. In : Sickles EA, Mendelson EB, Morris EA, Creech WE, Butler PF, editors. ACR breast imaging reporting and data system atlas. 5th ed. Reston, VA: American College of Radiology;2013. p. 570–625.

16. Kopans DB, D'Orsi CJ, Adler DD, Bassett LW, Brenner RJ, Dodd GD, et al. Breast imaging reporting and data system. 4th ed. Reston, VA: American College of Radiology;2003. p. 229–251.

17. Dorsi CJ, Bassett LW, Feig SA. Illustrated breast imaging reporting and data system. 3rd ed. Reston, Va: American College of Radiology;1998.

18. NCI-funded Brest Cancer Surveillance Consortium. Performance Benchmarks for Screening Mammography. Published 2013. Accessed Apr 18, 2018. Avaiable at. http://www.bcsc-research.org/statistics/benchmarks/screening/index.html.

19. Rosenberg RD, Yankaskas BC, Abraham LA, Sickles EA, Lehman CD, Geller BM, et al. Performance benchmarks for screening mammography. Radiology. 2006; 241:55–66.

20. Moon WK. The American Cancer Society’s change of guidelines for breast cancer screening and its implications. J Korean Soc Breast Screening. 2015; 12:135–138.

21. Kim SY, Kim EK. Benefits and harms of breast screening: focused on updated Korean guideline for breast cancer screening. J Korean Soc Radiol. 2016; 74:147–155.

22. Kim KW, Lee EH, Kim JY, Park YM, Kim HJ, Choi EJ, et al. Effectiveness of mammography boot camp for radiology residents. J Korean Soc Radiol. 2017; 76:30–38.

23. Amir E, Evans DG, Shenton A, Lalloo F, Moran A, Boggis C, et al. Evaluation of breast cancer risk assessment packages in the family history evaluation and screening programme. J Med Genet. 2003; 40:807–814.

24. Joseph KR, Edirimanne S, Eslick GD. The association between breast cancer and thyroid cancer: a meta-analysis. Breast Cancer Res Treat. 2015; 152:173–181.

25. Lee EH, Park B, Kim NS, Seo HJ, Ko KL, Min JW, et al. The Korean guideline for breast cancer screening. J Korean Med Assoc. 2015; 58:408–419.