www.screeningbc.ca SCREENING MAMMOGRAPHY PROGRAM Screening
Mammography in 2014: Still Controversial? Dr. Christine Wilson
MEDICAL DIRECTOR, SCREENING MAMMOGRAPHY PROGRAM BC CANCER
AGENCY
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www.screeningbc.ca Faculty/Presenter Disclosure Faculty:
Christine Wilson MD Relationships with commercial interests:
Medical Director Screening Mammography Program of BC
(www.screeningbc.ca/breast)www.screeningbc.ca/breast
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www.screeningbc.ca Background SMP QM practices Controversies
Overdiagnosis Breast density Informed Decision Making Breast Cancer
Screening
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www.screeningbc.ca There are 4 population- based screening
programs in BC: Screening Mammography Program (SMP) Cervical Cancer
Screening Program (CCSP) Colon Screening Program Hereditary Cancer
Program (HCP) Organized Screening Programs
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www.screeningbc.ca Screening Mammography Program TARGET
POPULATION: Women age 50-69 years Service also available to women
age 40-49 & 70+ SCREENING TEST:Two-view screening mammograms
offered across BC RESULTS:Screen read by a radiologist Results
mailed to both patient and her health care provider REMINDER:Mailed
to patient when time to re-screen STATISTICS There are 37 centers
and 3 mobiles that perform screening mammography in BC 285,000
mammograms are performed annually 7.5% or ~ 21,400 patients are
referred for further investigation Every year, approximately 1,400
cancers are found by screening 81% of cancers are found in women
age 50 and over Participation rate for ages 50-69 is about 52%
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www.screeningbc.ca Screening Mammography Program Screener QA
process initial 2 years of clinical experience and read 2500
mammograms 40 hours of Category 1 breast imaging credits in past 5
yrs Attendance at 2 formal mammography training courses of 2 to 3
days duration with a screening mammography component at least one
within past 3 yrs Pass a standardized test of 100 cases
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www.screeningbc.ca Screening Mammography Program Screeners QA
process ongoing Read a minimum of 2500 cases per year Attend an
annual conference in breast imaging (SMP Forum every other
year)
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www.screeningbc.ca Screening Mammography Program Screeners QA
process ongoing Statistics kept on abnormal call rate, cancer
detection rate, PPV, sensitivity and specificity and given to each
screener annually All are expected to maintain benchmarks:
Standardized cancer detection rate > 5/1000 Proportion of early
stage cancer >60% (DCIS & IDC
www.screeningbc.ca SMP Performance vs Canadian Standards Women
50 - 69 National Standards BC Abnormal Call Rate First
Screens3.0/10003.9 Inv Tumour size 25%35% Inv Tumour size 50%62%
Node ve Cases of Inv Ca>70%78%
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www.screeningbc.ca SMP Performance vs Canadian Standards Women
50 - 69 National StandardsBC Diagnostic Interval No biopsy>90%
in 5 weeks81.3% Biopsy>90% in 7 weeks63.6% Benign Core Biopsy
Rate/1000 First Screens26.4/1000 Subsequent Screens6.3/1000
Benign/Malignant Core Biopsy First Screens5.6/1000 Subsequent
Screens1.6/1000 Benign/Malignant Open Biopsy First Screens