title: Implementation of a clinical quality control program in a mammography screening service of Brazil.
abstract: OBJECTIVE
  To evaluate the effect of a clinical quality control program on the final quality of a mammography screening service.
  
  
  METHODS
  We conducted retrospective assessment of the clinical quality of 5,000 mammograms taken in a Mammography Screening Program between November 2010 and September 2011, following the implementation of a Clinical Quality Control Program based on the European Guidelines.
  
  
  RESULTS
  Among the 105,000 evaluated quality items, there were 8,588 failures (8.2%) - 1.7 failures per examination. Altogether, 89% of the failures were associated with positioning. The recall rate due to a technical error reached a maximum of 0.5% in the early phase of the observation period and subsequently stabilized (0.09%).
  
  
  CONCLUSIONS
  The ongoing education and monitoring combined with personalized training increased the critical thinking of the involved professionals, reducing the technical failures and unnecessary exposure of patients to radiation, with substantial improvement in the final quality of mammography.
authors.affiliation: Department of Cancer Prevention, Barretos Cancer Hospital, Barretos, Brazil dra.silviasabino@gmail.com.
authors.forename: Silvia Maria Prioli
authors.initials: SM
authors.lastname: DE Souza Sabino
authors.affiliation: Department of Cancer Prevention, Barretos Cancer Hospital, Barretos, Brazil.
authors.forename: Thiago Buosi
authors.initials: TB
authors.lastname: Silva
authors.affiliation: Department of Cancer Prevention, Barretos Cancer Hospital, Barretos, Brazil.
authors.forename: Anapaula Hidemi Uema
authors.initials: AH
authors.lastname: Watanabe
authors.affiliation: Teaching and Research Institute, Barretos Cancer Hospital, Barretos, Brazil Department of Oncology & Radiotherapy, Turku University Hospital, Turku, Finland.
authors.forename: Kari
authors.initials: K
authors.lastname: Syrjänen
authors.affiliation: Teaching and Research Institute, Barretos Cancer Hospital, Barretos, Brazil.
authors.forename: André Lopes
authors.initials: AL
authors.lastname: Carvalho
authors.affiliation: Department of Cancer Prevention, Barretos Cancer Hospital, Barretos, Brazil.
authors.forename: Edmundo Carvalho
authors.initials: EC
authors.lastname: Mauad
mesh_terms: D001938:Brazil; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D055088:Early Detection of Cancer / Q000379:methods / Q000592:standards; D005260:Female; D006801:Humans; D008327:Mammography / Q000592:standards; D009313:National Health Programs; D011785:Quality Assurance, Health Care; D011786:Quality Control; D019984:Quality Indicators, Health Care; D012307:Risk Factors; D012680:Sensitivity and Specificity
keywords: Breast cancer; in-service training; mammography; mobile units; quality control; screening programs