Low-cost screening mammography: report on finances and review of 21,716 consecutive cases

A review of the results of 21,716 mammograms obtained at a low-cost screening center is presented, along with a report on the finances of that center. A total of 142 cancers were discovered, 12 of which gave false-negative results at mammography. The sensitivity was 91.5% and the specificity 90%. The positive predictive value for lesions categorized as "suspicious for malignancy" was 54%. Thirty-one percent of the cancers were "minimal," in other words, in situ or less than 1 cm in diameter and with no tumor-positive lymph nodes. An average of 42 examinations were performed each day at a cost of +28 each. Nonphysician expenses were +16 for each examination, leaving +12 per examination as professional revenue. This project demonstrates that high-quality, low-cost screening mammography can be provided if the volume is adequate and if there is sufficient attention to detail.