title: Clinical outcome assessment in mammography: an audit of 7,506 screening and diagnostic mammography examinations.
abstract: OBJECTIVE
  To perform an audit of our routine mammographic practice and to compare our results to performance benchmarks.
  
  
  METHODS
  We analyzed the outcomes of 7,506 consecutive examinations performed in 1 year. Screening and diagnostic cases were evaluated separately and mammographic assessments were based on the Breast Imaging Reporting and Data System (BI-RADS) classification.
  
  
  RESULTS
  In 6,858 (91%) screening and 648 (9%) diagnostic cases, outcomes varied substantially. The recall rate was 10.9%. Estimated sensitivity and specificity were similar (100% vs. 98% and 88% vs. 94%) in the screening and diagnostic groups. Positive predictive values (PPV1, PPV2, and PPV3) were higher in the diagnostic group compared to the screening group (64%, 65%, and 68% vs. 4.9%, 33%, and 39%, respectively). Cancer outcomes in the screening and diagnostic groups were, respectively, as follows: cancer detection rate, 6.1 per thousand vs. 86.4 per thousand; mean invasive cancer size, 15.7 mm vs. 24.5 mm; minimal cancers, 38% vs. 19%; stage 0-1 cancers, 50% vs. 21%; and lymph node negativity, 76% vs. 29%.
  
  
  CONCLUSIONS
  The measures of our screening outcomes were concordant with the literature and the performance benchmarks for screening mammography; however, in our diagnostic group, the reasons for the higher PPV, higher cancer detection rate, and the diagnosis of cancer in a more advanced stage compared to the performance benchmarks should be investigated with more detailed periodic audits.
authors: Department of Radiology, Gazi University School of Medicine, Ankara, Turkey. isiltuncbilek@yahoo.com
authors: Işil
authors: I
authors: Tunçbilek
authors: Ayşegül
authors: A
authors: Ozdemir
authors: Serap
authors: S
authors: Gültekin
authors: Törel
authors: T
authors: Oğur
authors: Rabia
authors: R
authors: Erman
authors: Cemal
authors: C
authors: Yüce
mesh_terms: D019985:Benchmarking; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods / Q000706:statistics & numerical data*; D008485:Medical Audit; D008875:Middle Aged; D009367:Neoplasm Staging; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014421:Turkey / Q000453:epidemiology