Abstract
Purpose
Our purpose was to compare mammographic positioning quality of new (NR) versus experienced screening radiographers (ER) in the Netherlands.
Methods and Materials
Before starting to work in breast screening, NR must complete an education programme including a theoretical course (four days), practical training (six weeks), and a portfolio-review of 50 mammographic screening examinations performed by the radiographer. Furthermore, Dutch screening has an extensive system of quality assurance, including an audit-review of positioning quality of mammograms by ER. We analysed 13,520 portfolio views (NR) and 14,896 audit views (ER) based on pre-specified criteria, e.g., depiction of inframammary angle.
Results
Overall positioning was more adequate for NR than ER (CC views: 97 % versus 86 %, p = 0.00; MLO views: 92 % versus 84 %, p = 0.00). NR scored better for most of the CC-criteria and showed, for instance, less folds (inadequate: 10 % versus 16 %, p = 0.00). In contrast, NR encountered more difficulties for MLO views in, for example, depiction of infra-mammary angle (inadequate: 38 % versus 34 %, p = 0.00). Overall, mammograms from NR were more often considered adequate, because of less severe errors.
Conclusion
NR perform better than ER in overall positioning technique. These results stress the need for continuous monitoring and training in breast screening programmes to keep positioning skills up to date.
Key Points
• We evaluated positioning quality of new and experienced Dutch screening radiographers.
• New radiographers outperform their experienced colleagues in mammographic positioning quality.
• New radiographers make less severe errors compared to experienced colleagues.
• There is a need for a continuous individual monitoring and feedback system.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Rauscher GH, Conant EF, Khan JA, Berbaum ML (2013) Mammogram image quality as a potential contributor to disparities in breast cancer stage at diagnosis: an observational study. BMC Cancer. doi:10.1186/1471-2407-13-208
Klabunde C, Bouchard F, Taplin S, Scharpantgen A, Ballard-Barbash R (2001) Quality assurance for screening mammography: an international comparison. J Epidemiol Community Health 55:204–212
Holland R, Rijken HJ, Hendriks JH (2007) The Dutch population-based mammography screening: 30-years experience. Breast Care 2:12–18
National Evaluation Team for Breast Cancer Screening. National evaluation of breast cancer screening in the Netherlands 1990 – 2011/2012. 2014. Rotterdam, Dept. of Public Health, Erasmus MC, University Medical Center Rotterdam
Perry N, Broeders M, de Wolf C, Tornberg S, Holland R, von Karsa L (2006) European guidelines for quality assurance in breast cancer screening and diagnosis, 4th edn. Office for Official Publications of the European Communities, Luxembourg
Buist DS, Ml A, Smith RA, Carney PA, Miglioretti DL, Monsees BS et al (2014) Effect of Radiologists' Diagnostic Work-up Volume on Interpretive Performance. Radiology 273:351–364
Miglioretti DL, Gard CC, Carney PA, Onega TL, Buist DS, Sickles EA et al (2009) When radiologists perform best: the learning curve in screening mammogram interpretation. Radiology 253:632–640
Miglioretti DL, Zhang Y, Johnson E, Lee C, Morin RL, Vanneman N et al (2014) Personalized technologist dose audit feedback for reducing patient radiation exposure from CT. J Am Coll Radiol 11:300–308
Ivers N, Jamtvedt G, Flottorp S, Young JM, Odgaard-Jensen J, French SD et al (2012) Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev. doi:10.1002/14651858
Gurdemir B, Aribal E (2012) Assessment of mammography quality in Istanbul. Diagn Interv Radiol. doi:10.4261/1305-3825
Acknowledgments
The scientific guarantor of this publication is Mireille. J.M. Broeders. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article, except Gerard J. den Heeten: Founder of a spinoff company from the Academic Medical Centre Amsterdam, Sigmascreening, but is not a shareholder. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper.
Institutional Review Board approval was not required because data were collected routinely in the context of a screening programme. Written informed consent was not required for this study because the data were obtained in the context of an agreement between the regional screening organisations and the Dutch Reference Centre for Screening. Women automatically consent to the use of their data for scientific purposes by participating in screening. The screening organisations are responsible for data delivery in accordance with privacy regulations, particularly regarding anonymizing data and potentially removing data of participants who objected to the exchange of personal data with specific organisations (opt-out procedure). Methodology: retrospective, cross sectional study / observational, performed at one institution.
The authors thank the screening organisations (Foundation of Population Screening East, Foundation of Population Screening Mid-West, Foundation of Population Screening South, and Foundation of Population Screening South-West) for providing the data.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
van Landsveld-Verhoeven, C., den Heeten, G.J., Timmers, J. et al. Mammographic positioning quality of newly trained versus experienced radiographers in the Dutch breast cancer screening programme. Eur Radiol 25, 3322–3327 (2015). https://doi.org/10.1007/s00330-015-3738-8
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00330-015-3738-8