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Breast cancer mammographic diagnosis performance in a public health institution: a retrospective cohort study

机译:公共卫生机构中的乳腺癌X线诊断性能:一项回顾性队列研究

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Objectives To evaluate the quality assurance of mammography results at a reference institution for the diagnosis and treatment of breast cancer in southern Brazil, based on the BIRADS (Breast Imaging Reporting and Data System) 5th edition recommendations for auditing purposes. Materials and methods Retrospective cohort and cross-sectional study with 4502 patients (9668 mammographies)) who underwent at least one or both breast mammographies throughout 2013 at a regional public hospital, linked to a federal public university. The results were followed until 31 December 2014, including true positives (TPs), true negatives (TNs), false positives (FPs), false negatives (FNs), positive predictive values (PPVs), negative predictive value (NPV), sensitivity and specificity, with a confidence interval of 95%. Results The study showed high quality assurance, particularly regarding sensitivity (90.22%) and specificity (92.31%). The overall positive predictive value (PPV) was 65.35%, and the negative predictive value (NPV) was 98.32%. The abnormal interpretation rate (recall rate) was 12.26%. Conclusions The results are appropriate when compared to the values proposed by the BIRADS 5th edition. Additionally, the study provided self-reflection considering our radiological practice, which is essential for improvements and collaboration regarding breast cancer detection. It may stimulate better radiological practice performance and continuing education, despite possible infrastructure and facility limitations. Main Messages ? Accurate quality performance rates are possible despite financial and governmental limitations. ? Low-income institutions should develop standardised teamwork to improve radiological practice. ? Regular mammography audits may help to increase the quality of public health systems.
机译:目的根据BIRADS(乳房成像报告和数据系统)第五版建议,评估巴西南部参考机构在乳癌诊断和治疗中的乳腺X线摄影结果的质量保证,以进行审核。材料和方法回顾性队列研究和横断面研究对象为4502例患者(9668例乳腺X线摄影),他们在2013年全年都在与联邦公立大学建立联系的地区公立医院接受了至少一项或两项乳房X线摄影。跟踪结果直到2014年12月31日,包括真阳性(TPs),真阴性(TNs),假阳性(FPs),假阴性(FNs),阳性预测值(PPV),阴性预测值(NPV),敏感性和特异性,置信区间为95%。结果该研究显示出高质量的保证,特别是在敏感性(90.22%)和特异性(92.31%)方面。总体阳性预测值(PPV)为65.35%,阴性预测值(NPV)为98.32%。异常解释率(召回率)为12.26%。结论与BIRADS第5版提出的值进行比较时,结果是适当的。此外,考虑到我们的放射学实践,该研究提供了自我反思,这对于改善和协作检测乳腺癌是必不可少的。尽管可能存在基础设施和设施限制,但它可能会激发更好的放射实践表现和继续教育。主要讯息?尽管有财政和政府方面的限制,仍可能有准确的质量绩效率。 ?低收入机构应发展标准化的团队合作,以改善放射学实践。 ?定期的乳房X光检查可能有助于提高公共卫生系统的质量。

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