Mammography screening

Exclusive biannual mammography screening for women ages 50-69 years reduces the mortality from breast cancer among participants by 35%. Compared with 50% of clinically detected cancers, only 20% of carcinomas detected in screening have nodal metastases, and up to 55% of screening carcinomas are in the T1 stage of "minimal cancer." In many European countries (including Sweden, Norway, the Netherlands, and Great Britain), mammography screening programmes have been established for more than 10 years. In Germany, the aim is to establish, by 2008, a nationwide organised programme on the basis of the European Guidelines for Quality Assurance. This goal requires 80-100 mammography screening units. The first screening units went into use in 2005. Women between 50 and 69 years are invited to participate in 2-year intervals.     

全数字化乳腺X线摄影与传统乳腺X线摄影对比分析

目的:探讨全数字化乳腺X线摄影(FFDM)与传统乳腺X线摄影(SFM)的临床应用效果.方法:回顾分析使用传统乳腺X线机及使用全数字化乳腺机摄影各800例的影像及临床资料,分别统计两组病例的平均曝光次数、平均检查时间,同时对乳房各部分细微结构显示率进行评价,并将两组病例中经手术病理证实为乳腺癌病例的病理结果与术前X线诊断作对照.结果:SFM组平均曝光次数5.12次/人,平均检查时间20分钟/人;FFDM组平均曝光次数4.22次/人,平均检查时间6.3分钟/人.同时清晰显示乳房各部分微细结构显示率为SFM组284例(35.5%);FFDM组791例(98.9%).SFM与FFDM诊断乳腺癌的敏感度、特异度、准确度分别为80.2%时87.5%;79.8%对85.2%;81.3%对88.5%.结论:与传统乳腺X线摄影对比,全数字化乳腺X线摄影操作简单,成像快捷,图像质量好,在乳腺癌(尤其是早期乳癌)诊断方面优于传统乳腺X线摄影.     

Mammography and litigation

Mammography is perhaps the most heavily legislated medical procedure, and medical malpractice lawsuits are filed against mammographers for several reasons, including mammogram misread and delayed diagnosis. Perhaps the driving force behind mammography litigation is public perception of mammography's effectiveness. Surveys have indicated that the public attributes 100% sensitivity to mammography, whereas its actual sensitivity is approximately 79%. Fear of litigation affects mammography practice, and several initiatives have been suggested to address the problem of rampant mammography litigation, including increasing public awareness, to improve working conditions for mammographers and to ensure the future of this lifesaving procedure.     

Mammography processor quality assurance

After completing this article on mammographic processing, readers will: Understand the relationship between mammography and breast cancer survival. Define quality assurance and quality control. Discuss the history of the Mammography Quality Standards Act. List the important considerations in processor setup. Name the tests in the medical physicist survey. Know how to perform daily processor quality control. Understand the importance of continuous quality improvement.     

Mammography coding and reimbursement

This article describes mammography coding and reimbursement, coding responsibilities for personnel and the importance of coding accuracy. After completing this article, the reader will: Recognize basic terms associated with mammography coding and reimbursement. Explain reimbursement differences between screening and diagnostic mammography. Understand the responsibilities of mammography facility personnel in accurate coding. Recognize the impact of coding, reimbursement and regulation on the economics of mammography practice. Explain basic coding concepts for screening, diagnostic and follow-up mammographic studies. Describe some new breast imaging technologies reimbursed by Medicare.     

Mammography in younger women

Breast imaging is not frequently performed in women aged 35 years or younger for several reasons. Approximately half of the radiographic examinations of a breast symptom give normal results because the expected density of the breast in younger women may obscure abnormalities. Results from biopsies performed subsequent to positive mammogram findings confirm the predominance of benign lesions; cancers are rarely observed. After reviewing the main breast diseases that occur in the 20- to 35-year-old age group, we evaluated the accuracy of mammography in diagnosing malignancy, and attempted to summarize guidelines for breast imaging in young women, whose breasts are quite sensitive to radiation.