EUROPEAN GUIDELINES FOR QUALITY ASSURANCE IN MAMMOGRAPHY...

Directorate-General For Health And Consumers

Sujets

• Cancer
• Medical diagnosis
• Preventive medicine
• Health care system
• Member state of the European Union

Informations

• Publié par: DIRECTORATE-GENERAL-FOR-HEALTH-AND-CONSUMERS
• Nombre de lectures: 266
• Langue: English
• Poids de l'ouvrage: 5 Mo

Extrait

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European guidelines for quality assurance
in mammography screening mim Ed mon
European Commission Cover: Fernando Ureña Rib, Duo Turbantes, Miami, private collection European guidelines for quality assurance
in mammography screening Third Ed mon
January 2001
Editors
N. Perry
M. Broeders
C. de Wolf
S. Törnberg
Technical editor
J. Schouten
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Europe Against Cancer A great deal of additional information on the European Union is available on the Internet.
It can be accessed through the Europa server (http://europa.eu.int).
Cataloguing data can be found at the end of this publication.
Luxembourg: Office for Official Publications of the European Communities, 2001
ISBN 92-894-1145-7
© European Communities, 2001
Reproduction is authorised provided the source is acknowledged.
Printed in Belgium John P. Sloane I 1946-2000 I
This edition is dedicated to the memory of our friend and colleague who pioneered the
quality assurance of breast pathology in the UK and throughout Europe
N. Perry
Quality Assurance Reference Centre
London Region Breast Screening Programme
St Bartholomew's Hospital
90 Bartholomew Close
London EC1A 7BE
United Kingdom
M. Broeders
Department of Epidemiology and
Biostatistics / EUREF Office 451
University Medical Centre Nijmegen
PO Box 9101
6500 HB Nijmegen
The Netherlands
C. de Wolf
Institute of Social and Preventive Medicine (IMSP)
University of Geneva
55 Bd de la Cluse
1205 Geneva
Switzerland
S. Törnberg
Cancer Screening Unit
Oncologic Centre
Karolinska Hospital
17176 Stockholm
Sweden
J. Schouten
EUREF Office 451
University Medical Centre Nijmegen
PO Box 9101
6500 HB Nijmegen
The Netherlands
European guidelines for quality assurance in mammography screening Third edition Contributors
N. Ascunce, Gobierno de Navarra, Programme Cancer de Mamma, Pamplona, Spain
R. Blarney, Professorial Unit of Surgery, Nottingham City Hospital, United Kingdom
M. Blichert-Toft, Department of Surgery, Rigshospitalet, Denmark
R. Bordón, Breast Unit, St. Anna Hospital, Turin, Italy
M. Broeders, Department of Epidemiology and Biostatistics / EUREF Office,
University Medical Centre Nijmegen, The Netherlands
J. Caseldine, NHS Breast Screening Programme, Sheffield, United Kingdom
L. Cataliotti, Instituto di Clinica Chirurgia, University of Florence, Italy
M. Codd, Department of Epidemiology, Mater Hospital, Dublin, Ireland
V. Distante, Instituto di Clinica Chirurgia, University of Florence, Italy
D. Giorgi, Unit of Epidemiology, CSPO, Florence, Italy
T. Gorey, Department of Surgery, Mater Hospital, Dublin, Ireland
J. Hendriks, National Expert and Training Centre for Breast Cancer Screening,
Nijmegen, The Netherlands
R. Holland, National Expert and Training Centre for Breast Cancer Screening,
Nijmegen, The Netherlands
L. Holmberg, Oncologic centre, Uppsala, Sweden
A. Linos, Department of Hygiene and Epidemiology, University Medical School,
Athens, Greece
D. Linos, Department of Surgery, Hospital Hygeia, 1st Surgical Clinic,
Athens, Greece
M. Mano, Breast Unit, St. Anna Hospital, Turin, Italy
R. Mansel, University Department of Surgery, University of Wales,
Cardiff, United Kingdom
W. Mattheiem, Institute Jules-Bordet, Brussels, Belgium
L. Nyström, Department of Public Health and Clinical Medicine Epidemiology,
University of Umeå, Sweden
N. O'Higgins, Department of Surgery, University College Dublin, St. Vincent's Hospital, Ireland
European guidelines for quality assurance in mammography screening Third edition N. Perry, London Region Breast Screening Programme, St. Bartholomew's Hospital,
London, United Kingdom
A. Ponti, CPO Piemonte, Turin, Italy
H. Rijken, National Expert and Training Centre for Breast Cancer Screening, Nijmegen,
The Netherlands
E. Riza, Department of Hygiene and Epidemiology, University Medical School, Athens, Greece
P. Roberts, Department of Surgery, University of Helsinki, Finland
F. Rochard, Institute Gustave Roussy, France
V. Rodrigues, Programa de Cancro de Mama, Liga Portuguesa Contra o Cancro, Coimbra,
Portugal
M. Rosselli del Turco, Breast Unit, CSPO, Florence, Italy
E. Rutgers, Department of Surgery, Netherlands Cancer Institute, The Netherlands
R. Sainsbury, University College Hospital - NHS Trust, 9th floor, St. Martin's House,
140 Tottenham Court Road, London W1P 9LM, UK
K. Schulz, Universitaets-Frauenklinik, Marburg, Germany
N. Segnan, CPO Piemonte, Turin, Italy
M. da Silva, Centro de Coimbra do Instituto Português de Oncologia de Francisco Gentil,
Portugal
M. Smola, Universitaetsklinik fur Chirurgie, Karl Franzens Universitaet, Austria
J. Sloanet, Department of Pathology, University of Liverpool, Liverpool, United Kingdom
M. Thijssen, National Expert and Training Centre for Breast Cancer Screening,
Nijmegen, The Netherlands
S. Törnberg, Cancer Screening Unit, Oncologic Centre, Karolinska Hospital, Stockholm,
Sweden
C. de Wolf, Institute of Social and Preventive Medicine (IMSP), University of Geneva, 55
Bd de la Cluse, 1205 Geneva, Switzerland
S. van Woudenberg, National Expert and Training Centre for Breast Cancer Screening,
Nijmegen, The Netherlands
K. Young, National Coordinating Centre for Physics of Mammography,
Guildford, United Kingdom
European guidelines for quality assurance in mammography screening Third edition Table of contents
Introduction 11 1
C±2QEpidemiological guidelines for quality assurance 15
in mammography screening
2.1 Introduction17
2.2 Local conditions governing the screeningprocessat19
the beginning of a breast screening programme
2.3 Invitation scheme 23
2.4 Screeningprocessandfurther assessment26
2.5 Diseasestageofscreen-detected cancers31
2.6 Treatmentofd cancers34
2.7 Followupofthetargetpopulation and ascertainment of interval cancers 38
2.8 Evaluationandinterpretation of screening outcomes 48
2.8.1Performanceindicators49
2.8.2Impactindicators50
2.8.3Cost-effectiveness54
2.9 Bibliography54
2.10 Glossary of terms58
■&Π The European protocol for the quality control of the physical 67
and technical aspects of mammography screening
Executive summary 67
3.1Introductiontothe measurements71
3.2Descriptionofthe s73
3.2.1X-raygeneration73
3.2.1.1 X-ray source732 Tube voltage77
3.2.1.3 AEC-system784 Compression 80
3.2.2 Bucky andimagereceptor81
3.2.2.1Antiscattergrid81 2 Screen-film81
3.2.3 Film processing82
3.2.3.1Baselineperformanceof the processor 822Filmandprocessor83
3.2.3.3 Darkroom85
3.2.4 Viewing conditions86
3.2.4.1 Viewing box 87
3.2.4.2 Ambient light87
3.2.5 Systemproperties88
3.2.5.1Dosimetry882Imagequality88
Europeanguidelinesforqualityassurance in mammography screeningThirdedition3.3 Daily and weekly QC tests 90
3.4 Definition of terms1
3.5 Tables7
3.6 Bibliography 10
Appendix 1: Film-parametersx 2: A method to correct for the film curve 109
Appendix 3: Typical values for other spectra and densities 11x 4: Low contrast visibility 111,
Appendix 5: Digital mammography 112 x 6: Completion forms for QC reporting4
]G Radiographical guidelines 127 &
4.1 Introduction9
4.2 Technical quality control
4.3 Ergonomie design of the machine 131
4.4 Mammographie examination2
4.4.1 Introduction to the examination
4.4.2 Starting the examination
4.4.3 Compression3
4.4.4 Positioning
4.4.5 Standard views
4.4.5.1 Cranio-caudal view4
4.4.5.2 Mediolateral oblique view5
4.4.6 Other additional views 136
4.5 Social skills
4.6 Consent7
4.7 Teamwork
4.8 Radiographic quality standards
4.9 Training 138
4.9.1 Academic component
4.9.2 Clinicalt9
4.9.3 Certification
4.9.4 Continuing education
4.10 Staffing levels and working practices 13
4.11 Summary 140
4.11.1 Skills2 Technical quality control
4.11.3 Multidisciplinary teamwork4 Training1
4.12 Conclusion
4.13 Bibliography
European guidelines for quality assurance in mammography screening Third edition Ç2JG Radiological guidelines 143
5.1 Introduction145
5.2 Imagequality146
5.3 Radiologistperformanceissues147
5.3.1Advancementofthetime of diagnosis 147
5.3.2Reductionofadverse effects149
5.4 Operatingprocedures152
5.4.1Viewingconditions152
5.4.2 Single/doublereading153
5.4.3 Assessment of screen­detectedabnormalities153
5.4.4 Quality assurance organisation 154
5.4.5 Number of views154
5.4.6 Localisationofnon­palpablelesions155
5.5 Interval cancers 155
5.6 Professionalrequirements158
\¿)n Qualityassuranceguidelines for pathology in 159
mammographyscreening-non-operativediagnosis
6.1 Introduction161
6.2 Cytopathology162
6.2.1 Registering basic cytopathologyinformation162
6.2.2 Cytopathology reporting categories163
6.2.3 y quality assurance 165
6.3 Needle core biopsy 170
Qualityassuranceguidelinesforpathology in mammography 173?■
screening-openbiopsyand resectionspecimens
7.1 Introduction175
7.2 M