Breast cancer screening in the Netherlands: audit and training of radiologists

摘要: Abstract The National Expert and Training Centre has for the past 15 years been in charge of medical technical quality control Dutch population-based screening program. Audit is an important tool keeping up with improving standards. Between 1994 2002, we visited most 28 central units program twice, making over 50 audits total. During audits, reviewed interval cancers Stage II screen-detected cancers. Referral rates subsequent exams varied from 0.43% to 1% first series had increased 0.6% 1.6% next audits. This led higher detection (first 2.4–4.0/1,000; second 3.6–4.7/1,000). For women aged 69 years, rate was 3.9 per 1,000 1999. Review showed fewer cases tumor signs retrospectively visible on previous mammograms 54%, 44%). Because small numbers (usually 80 interval- 40 cancers), resulting figures have relatively wide confidence intervals. Presentation audit results scatter diagrams can aid comparison other units. In units, 80% malignancies are T1 invasive tumors or ductal carcinoma situ. 70% cancers, axillary lymph nodes were negative. Results generally agreement expectations stated at start