Lee Christoph I, Bogart Andy, Hubbard Rebecca A, Obadina Eniola T, Hill Deirdre A, Haas Jennifer S, Tosteson Anna N A, Alford-Teaster Jennifer A, Sprague Brian L, DeMartini Wendy B, Lehman Constance D, Onega Tracy L
Department of Radiology, University of Washington School of Medicine, 825 Eastlake Ave East, Seattle, WA 98109; Department of Health Services, University of Washington School of Public Health, Seattle, Washington.
Group Health Research Institute, Seattle, Washington.
Acad Radiol. 2015 Jul;22(7):846-52. doi: 10.1016/j.acra.2015.02.011. Epub 2015 Apr 4.
To determine the relationship between screening mammography facility characteristics and on-site availability of advanced breast imaging services required for supplemental screening and the diagnostic evaluation of abnormal screening findings.
We analyzed data from all active imaging facilities across six regional registries of the National Cancer Institute-funded Breast Cancer Surveillance Consortium offering screening mammography in calendar years 2011-2012 (n = 105). We used generalized estimating equations regression models to identify associations between facility characteristics (eg, academic affiliation, practice type) and availability of on-site advanced breast imaging (eg, ultrasound [US], magnetic resonance imaging [MRI]) and image-guided biopsy services.
Breast MRI was not available at any nonradiology or breast imaging-only facilities. A combination of breast US, breast MRI, and imaging-guided breast biopsy services was available at 76.0% of multispecialty breast centers compared to 22.2% of full diagnostic radiology practices (P = .0047) and 75.0% of facilities with academic affiliations compared to 29.0% of those without academic affiliations (P = .04). Both supplemental screening breast US and screening breast MRI were available at 28.0% of multispecialty breast centers compared to 4.7% of full diagnostic radiology practices (P < .01) and 25.0% of academic facilities compared to 8.5% of nonacademic facilities (P = .02).
Screening facility characteristics are strongly associated with the availability of on-site advanced breast imaging and image-guided biopsy service. Therefore, the type of imaging facility a woman attends for screening may have important implications on her timely access to supplemental screening and diagnostic breast imaging services.
确定乳腺钼靶筛查机构特征与补充筛查及异常筛查结果诊断评估所需的高级乳腺成像服务现场可用性之间的关系。
我们分析了美国国立癌症研究所资助的乳腺癌监测联盟六个区域登记处所有活跃成像机构在2011 - 2012历年提供乳腺钼靶筛查的数据(n = 105)。我们使用广义估计方程回归模型来确定机构特征(如学术隶属关系、执业类型)与现场高级乳腺成像(如超声[US]、磁共振成像[MRI])和图像引导活检服务可用性之间的关联。
任何非放射科或仅乳腺成像的机构均未提供乳腺MRI。多专科乳腺中心有76.0%可同时提供乳腺US、乳腺MRI和成像引导乳腺活检服务,而全诊断放射科执业机构这一比例为22.2%(P = 0.0047);有学术隶属关系的机构中有75.0%可提供这些服务,无学术隶属关系的机构这一比例为29.0%(P = 0.04)。多专科乳腺中心有28.0%可同时提供补充筛查乳腺US和筛查乳腺MRI,全诊断放射科执业机构这一比例为4.7%(P < 0.01);学术机构中有25.0%可提供,非学术机构这一比例为8.5%(P = 0.02)。
筛查机构特征与现场高级乳腺成像和图像引导活检服务的可用性密切相关。因此,女性进行筛查所前往的成像机构类型可能对其及时获得补充筛查和乳腺诊断成像服务具有重要影响。