Purpose: To obtain performance indicators of screening mammography in gynecologic patients during a one year period and compare with ACR recommendation.
Materials and Methods: We retrospectively reviewed mammographic reports of 4,345 gynecologic patients who took screening mammography between Mar 1, 2004 and Feb 28, 2005. We retrospectively input data of breast parenchymal composition and category which were recorded in the reports according to the American College of Radiology Breast Imaging Reporting and Data System (ACR BI-RADS)]. We also retrospectively review following ultrasound examinations, pathologic results, and follow up breast imaging till Mar 1 2006.
Results: The mean age was 51.5% [Age < 40: 258(5.9%), 40≤Age<50: 1,559 (35.9%), 50 ≤ Age: 2528 (58.2%)]. Dense breast parenchymal composition was shown in 2809 (64.6%). 416 women revealed Category 0, 4, 5, mammography positive, therefore recall rate is 9.6%. Among 416 women, 26 patients got recommendation for biopsy, therefore biopsy recommendation rate 는 0.6%, and 8 cancers were diagnosed. The cancer detection rate was 1.8/1,000 screenee (8/4,345). PPV2 was 30.8%. The rate of breast cancer less than stage 1 was 7(87.5%) and rate of minimal breast cancer, including invasive cancer less than 1cm and ductal carcinoma in situ was 6(75%). False negative cases were found during 1 year follow up, and 2 cases of true positive and 2 cases of false negative cases were estimated among the women which follow up images were not available. The calculated PPV1 was 2.4%, sensitivity was 71.4%, and
specificity was 90.6%.
Conclusion: Our data showed favorable recall rate, PPV2, the rate of les than stage1, the rated of minimal cancer, specificity, but lower sensitivity and PPV1 compared to the ACR recommendation. Medical audit of mammography is essential way for improving performance indices.
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