Nilgün GÜLDOĞAN, Damla GÜRLEYİK, Fikret KÜÇÜKKAYA, Erkin ARIBAL

Mamografi Tarama Sonuçlarının BI-RADS’a Göre Değerlendirilmesi; Bir Meme Görüntüleme Merkezinin Tıbbi Denetimi

Amaç: Kliniğimizde 2017 ve 2018 yıllarında yapılan tarama mamografilerinin sonuçlarının American College of Radiology (ACR) önerileri doğrultusunda karşılaştırmalı olarak değerlendirmeyi amaçladık. Yöntem: 14 Mart 2017 ve 31 Aralık 2018 tarihleri arasında yapılan tarama mamografi sonuçlarını kaydedip analiz ettik. Bu analizleri kullanarak tarama mamografi uygulamalarımızı denetledik. Sonuçlar ACR BI-RADS önerileri ve performans kriterlerine göre değerlendirildi. Bulgular: Meme kanseri öyküsü bulunmayan kadınlara yapılan tarama mamografisi sayısı toplam 2413‘tü. Pozitif Öngörü Değeri (PÖD)1, PÖD2 ve PÖD3 hesaplamalarımız sırasıyla %5,6, %30,8 ve %52,9 idi. Geri çağırma oranı ise %11’di. Kanser saptama oranı, minimal kanser oranı, erken evre kanser oranı ve lenf nodu negatifliği çıktıları sırasıyla %0,74, %50, %77 ve %64 olarak saptandı. Sonuç: Tarama mamografilerinin değerlendirme çıktılarının ACR performans kriterleri ile uyumlu olduğu görüldü. Erken evre meme kanseri saptama oranı istenildiği gibi yüksek olmasına rağmen aksiller lenf nodu negatiflik oranının istenilen %75’lik oranın altında kaldığı görüldü. Medikal denetleme, meme görüntüleme biriminin tarama ve tanı çalışmalarının etkinliğini gösterme ve birimin uygulamalarının iyileşmesi için etkili bir geri bildirim yöntemi olması açısından önemlidir.

BI-RADS Outcome Assessment of Mammography Screening; Medical Audit of a Breast Imaging Center

Aim: To audit our mammography screening practice according to the American College of Radiology (ACR) recommendations in the years 2017 and 2018. Method: We documented and analyzed our breast imaging data collected between March 14th, 2017 and December 31st, 2018 and performed a medical audit related to our mammography screening practice. The results were evaluated according to ACR BI-RADS recommendations and performance benchmarks. Results: The total number of mammographic screening patients who had no personal history of breast cancer was 2413 in 2017 and 2018. Our PPV1, PPV2 and PPV3 values were 5.6%, 30.8%, 52.9% accordingly. The recall rate was 11%. Outcomes for cancer detection rate, minimal cancer rate, early-stage cancer rate and lymph node negativity were 0.74%, 50%, 77% and 64% respectively. Conclusion: The mammographic screening outcomes are in accordance with ACR performance benchmarks. Despite a desired high early cancer detection rate, axillary lymph node negativity was found to be below the desired range of 75%. Medical auditing is important for a breast imaging unit to monitor the effectiveness of screening and diagnostic procedures and presents as an effective feedback tool to improve the practice.

Keywords:

Medical audit mammography, ultrasound, automated breast ultrasound, screening,

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