Medical audit of a rapid-throughput mammography screening practice: methodology and results of 27,114 examinations.
Medical audit results from the entire experience of a rapid-throughput mammography screening practice are presented, comprising 27,114 examinations conducted from April 1985 to September 1989. The authors screened a self-selected physician-referred population, almost 94% of whom were asymptomatic. Estimated sensitivity of initial mammography interpretation was 93.1% with a specificity of 94.2% and a positive predictive value of 10.0%. Biopsies prompted by screening yielded a diagnosis of malignancy in 32.1% of cases; 170 breast cancers were identified, 67.1% requiring mammographic needle localization. Median cancer size was 12 mm, the rate of axillary nodal metastasis was 11.0%, and the systemic metastasis rate was 1.2%. Of the cancers found, 76.5% were stage 0 or stage 1. Conducting a medical audit is the most convincing way to demonstrate the success of a mammography screening practice, thereby providing this important information for the benefit of screenees, referring physicians, third-party payers, and the personnel who perform the screening.
Sickles
E A
EA
Department of Radiology, University of California School of Medicine, San Francisco 94143-0628.
Ominsky
S H
SH
Sollitto
R A
RA
Galvin
H B
HB
Monticciolo
D L
DL
D000328:Adult; D000368:Aged; D001706:Biopsy; D001943:Breast Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000517:prevention & control; D005260:Female; D006801:Humans; D008327:Mammography; D008403:Mass Screening; D008485:Medical Audit; D008875:Middle Aged; D010173:Palpation; D011785:Quality Assurance, Health Care