Community-based mammography practice: services, charges, and interpretation methods.
OBJECTIVE
The purpose of our study was to accurately describe facility characteristics among community-based screening and diagnostic mammography practices in the United States.


METHODS
A survey was developed and applied to community-based facilities providing screening mammography in three geographically distinct locations in the states of Washington, Colorado, and New Hampshire. The facility survey was conducted between December 2001 and September 2002. Characteristics surveyed included facility type, services offered, charges for screening and diagnostic mammography, information systems, and interpretation methods, including the frequency of double interpretation.


RESULTS
Among 45 responding facilities, services offered included screening mammography at all facilities, diagnostic mammography at 34 facilities (76%), breast sonography at 30 (67%), breast MRI at seven (16%), and nuclear medicine breast scanning at seven (16%). Most facilities surveyed were radiology practices in nonhospital settings. Eight facilities (18%) reported performing clinical breast examinations routinely along with screening mammography. Only five screening sites (11%) used computer-aided detection (CAD) and only two (5%) used digital mammography. Nearly two thirds of facilities interpreted screening mammography examinations on-site, whereas 91% of facilities interpreted diagnostic examinations on-site. Only three facilities (7%) interpreted screening examinations on line as they were performed. Approximately half of facilities reported using some type of double interpretation, although the methods of double interpretation and the fraction of cases double-interpreted varied widely across facilities. On average, approximately 15% of screening examinations and 10% of diagnostic examinations were reported as being double-interpreted.


CONCLUSIONS
Comparison of this survey's results with those collected a decade earlier indicates dramatic changes in the practice of mammography, including a clear distinction between screening and diagnostic mammography, batch interpretation of screening mammograms, and improved quality assurance and medical audit tools. Diffusion of new technologies such as CAD and digital mammography was not widespread. The methods of double-interpretation and the fraction of cases double-interpreted varied widely across study sites.
Hendrick
R Edward
RE
Department of Radiology, Lynn Sage Comprehensive Breast Center, Northwestern University Feinberg School of Medicine, Galter Pavilion, 13th Floor, 251 E Huron St., Chicago, IL 60611, USA. ehendrick@radiology.northwestern.edu
Cutter
Gary R
GR
Berns
Eric A
EA
Nakano
Connie
C
Egger
Joseph
J
Carney
Patricia A
PA
Abraham
Linn
L
Taplin
Stephen H
SH
D'Orsi
Carl J
CJ
Barlow
William
W
Elmore
Joann G
JG
D001943:Breast Neoplasms / Q000517:prevention & control*; D003120:Colorado; D003153:Community Health Services / Q000592:standards / Q000706:statistics & numerical data; D003936:Diagnosis, Computer-Assisted / Q000706:statistics & numerical data; D005249:Fees and Charges; D005260:Female; D005568:Forms and Records Control; D006801:Humans; D008327:Mammography / Q000592:standards* / Q000706:statistics & numerical data; D008403:Mass Screening / Q000191:economics / Q000458:organization & administration*; D008485:Medical Audit / Q000379:methods*; D009513:New Hampshire; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data; D014861:Washington