Complete internal audit of a mammography service in a reference institution for breast imaging.
OBJECTIVE
Undertaking of a complete audit of the service of mammography, as recommended by BI-RADS(®), in a private reference institution for breast cancer diagnosis in the city of São Paulo, SP, Brazil, and comparison of results with those recommended by the literature.


METHODS
Retrospective, analytical and cross-sectional study including 8,000 patients submitted to mammography in the period between April 2010 and March 2011, whose results were subjected to an internal audit. The patients were followed-up until December 2012.


RESULTS
The radiological classification of 7,249 screening mammograms, according to BI-RADS, was the following: category 0 (1.43%), 1 (7.82%), 2 (80.76%), 3 (8.35%), 4 (1.46%), 5 (0.15%) and 6 (0.03%). The breast cancer detection ratio was 4.8 cases per 1,000 mammograms. Ductal carcinoma in situ was found in 22.8% of cases. Positive predictive values for categories 3, 4 and 5 were 1.3%, 41.3% and 100%, respectively. In the present study, the sensitivity of the method was 97.1% and specificity, 97.4%.


CONCLUSIONS
The complete internal audit of a service of mammography is essential to evaluate the quality of such service, which reflects on an early breast cancer detection and reduction of mortality rates.
Specialist in Breast Imaging, MD, Second Assistant Physician, Santa Casa de São Paulo, Coordinator for the Unit of Interventional Procedures, FEMME - Laboratório da Mulher, São Paulo, SP, Brazil.
Gustavo Machado
GM
Badan
College Instructor, Director, Unit of Imaging Diagnosis at Santa Casa de São Paulo, Coordinator for the Unit of Radiology, FEMME - Laboratório da Mulher, São Paulo, SP, Brazil.
Décio
D
Roveda Júnior
Physician Assistant, Coordinator for the Unit of Breast Imaging, Department of Medical Practice, School of Medical Sciences, Santa Casa de São Paulo, Coordinator for the Service of Mammography, FEMME - Laboratório da Mulher, São Paulo, SP, Brazil.
Carlos Alberto Pecci
CA
Ferreira
Graduate Student of Medicine at School of Medical Sciences, Santa Casa de São Paulo, São Paulo, SP, Brazil.
Ozeas Alves
OA
de Noronha Junior
Audit of mammography service; BI-RADS; Breast cancer; Mammographic screening; Percutaneous biopsy; Positive predictive value