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[Effectiveness of a quality control program in mammography for the Brazilian National Health System]
Rosangela da Silveira Corrêa1, Ruffo Freitas-Junior, João Emílio Peixoto
1Rede Goiana de Pesquisa em Mastologia, Centro Regional de Ciências Nucleares do Centro-Oeste, Comissão Nacional de Energia Nuclear, Abadia de Goiás, GO, Brasil. rcorrea@cnen.gov.br
Objective:
To assess the effectiveness of a quality control program in mammography services of the Brazilian National Health System (SUS).
Methods:
A prospective study using temporal analysis of a health surveillance action was conducted. A total of 35 service providers that had mammography equipment in operation and regularly performed exams between 2007 and 2009 in the state of Goiás, Central-Western Brazil, participated in this study. Services were assessed during three site visits by performance testing of mammography equipment, film processors, and other materials, and image quality and entrance surface dose in a phantom were also assessed. Each service was scored according to the percentage of tests that conformed to standards.
Results:
The mean percentage for compliance among the participating service providers were 64.1% (± 13.3%) in the first visit, 68.4% (± 15.9%) in the second, and 77.1% (± 13.3%) in the third (p < 0.001). The main improvements resulted from adjustments to the breast compression force, the automatic exposure control system, and the alignment of the compression paddle. The doses measured were within the conformity range in 80% of the services assessed.
Conclusions:
The implementation of this program in the mammography services was effective at improving the operational parameters of the mammography machines, although 40% of the services did not reach the acceptable level of 70%. This result indicates the need to continue this health surveillance action.