Badan Gustavo Machado, Roveda Júnior Décio, Ferreira Carlos Alberto Pecci, de Noronha Junior Ozeas Alves
Specialist in Breast Imaging, MD, Second Assistant Physician, Santa Casa de São Paulo, Coordinator for the Unit of Interventional Procedures, FEMME - Laboratório da Mulher, São Paulo, SP, Brazil.
College Instructor, Director, Unit of Imaging Diagnosis at Santa Casa de São Paulo, Coordinator for the Unit of Radiology, FEMME - Laboratório da Mulher, São Paulo, SP, Brazil.
Radiol Bras. 2014 Mar-Apr;47(2):74-8. doi: 10.1590/S0100-39842014000200007.
Undertaking of a complete audit of the service of mammography, as recommended by BI-RADS(®), in a private reference institution for breast cancer diagnosis in the city of São Paulo, SP, Brazil, and comparison of results with those recommended by the literature.
Retrospective, analytical and cross-sectional study including 8,000 patients submitted to mammography in the period between April 2010 and March 2011, whose results were subjected to an internal audit. The patients were followed-up until December 2012.
The radiological classification of 7,249 screening mammograms, according to BI-RADS, was the following: category 0 (1.43%), 1 (7.82%), 2 (80.76%), 3 (8.35%), 4 (1.46%), 5 (0.15%) and 6 (0.03%). The breast cancer detection ratio was 4.8 cases per 1,000 mammograms. Ductal carcinoma in situ was found in 22.8% of cases. Positive predictive values for categories 3, 4 and 5 were 1.3%, 41.3% and 100%, respectively. In the present study, the sensitivity of the method was 97.1% and specificity, 97.4%.
The complete internal audit of a service of mammography is essential to evaluate the quality of such service, which reflects on an early breast cancer detection and reduction of mortality rates.
按照美国放射学会(ACR)乳腺影像报告和数据系统(BI-RADS®)的建议,对巴西圣保罗市一家乳腺癌诊断的私立参考机构的乳腺钼靶检查服务进行全面审核,并将结果与文献推荐的结果进行比较。
回顾性、分析性横断面研究,纳入2010年4月至2011年3月期间接受乳腺钼靶检查的8000例患者,其检查结果接受内部审核。对患者随访至2012年12月。
根据BI-RADS,7249例筛查乳腺钼靶的放射学分类如下:0类(1.43%)、1类(7.82%)、2类(80.76%)、3类(8.35%)、4类(1.46%)、5类(0.15%)和6类(0.03%)。乳腺癌检出率为每1000例乳腺钼靶检查4.8例。22.8%的病例发现导管原位癌。3类、4类和5类的阳性预测值分别为1.3%、41.3%和100%。在本研究中,该方法的敏感性为97.1%,特异性为97.4%。
乳腺钼靶检查服务的全面内部审核对于评估该服务质量至关重要,这对早期乳腺癌检测和降低死亡率具有重要意义。