Surgical mammography reporting in a limited resource environment

Area of Science:

• Radiology
• Oncology
• Public Health

Background:

• Limited resources and radiologist availability in developing countries necessitate alternative approaches for mammography interpretation.
• Breast radiology services are often scarce in resource-restricted environments, impacting diagnostic capabilities.

Purpose of the Study:

• To evaluate the proficiency of dedicated breast surgeons in interpreting mammograms.
• To assess the feasibility of surgeon-led mammography interpretation in a developing country context.

Main Methods:

• Prospective data collection of mammograms performed at a tertiary hospital from January 2003 to June 2008.
• Analysis of mammography indications, outcomes, diagnostic procedures, and results, benchmarked against standard performance indicators.

Main Results:

• For palpable lumps, the cancer diagnosis rate was 640 per 1,000 investigations, with 95% accuracy for suspicious findings.
• Screening mammograms showed a cancer diagnosis rate of 11 per 1,000, with 96% of cancers detected at early stages (0-I).
• Surgeons demonstrated comparable diagnostic accuracy to radiologists, particularly in identifying early-stage cancers.

Conclusions:

• Dedicated breast surgeons possess comparable proficiency to radiologists in mammography interpretation.
• The non-availability of dedicated breast radiologists should not impede the development of breast units in resource-limited settings.