Download presentation
Presentation is loading. Please wait.
1
Breast Screening and Assessment
Women's Cancer Screening Collaborative March 2017
2
Forms of Health Tests Population Based Screening
Opportunistic Screening Targeted Risk Screening Routine Exam or Planned Opportunistic Screening Diagnostic Testing
3
Forms of Health Tests Population Based Screening
Opportunistic Screening Targeted Risk Screening Routine Exam or Planned Opportunistic Screening Diagnostic Testing
4
Symptomatic Clinical Abnormality High Risk < 40 yo
Diagnostic Testing
5
Asymptomatic No Clinical Findings Target Age Group
Population Based Screening Asymptomatic No Clinical Findings Target Age Group
6
Ideal Breast Process Detect Diagnose Treat Asymptomatic
No Clinical Findings Target Age Group Screening Read Assessment Clinic Breast Surgeon Symptomatic Clinical Abnormality High Risk < 40 yo GP Consult Diagnostic Radiology
7
Real Breast Process Detect Diagnose Treat Asymptomatic
No Clinical Findings Target Age Group Screening Read Assessment Clinic Breast Surgeon Symptomatic Clinical Abnormality High Risk < 40 yo GP Consult Diagnostic Radiology
8
Screening Read Asymptomatic No Clinical Findings Target Age Group GP Consult Diagnostic Radiology
9
Screening Benefits Free Optimised to serve asymptomatic population
Formal read process Sensitivity and Specificity tightly controlled Robust continuous QA Proven cost/benefit if asymptomatic
10
Diagnostic Radiology Benefits
Variable cost Optimised to solve diagnostic problems Increased sensitivity Low specificity? Variable read QA process Absolutely right for symptomatic Risk of overbiopsy in asymptomatic?
11
Real Breast Process Detect Diagnose Treat Asymptomatic
No Clinical Findings Target Age Group Screening Read Assessment Clinic Breast Surgeon Symptomatic Clinical Abnormality High Risk < 40 yo GP Consult Diagnostic Radiology
12
Right Tool for the Job
13
North Coast Service Screen 30000 Read 1000 Assess Biopsy 150 Treat
14
North Coast Service
15
North Coast Service
16
North Coast Service
18
Reading Agree Rescreen Read 1 and 2 Disagree Assess Read 3
19
Assessment Clinical X-Ray Ultrasound Highest Score DECISION TIME!!
Normal Biopsy Review
23
Current Controversies
Tomosynthesis in Screening Overdiagnosis Breast Density
24
On the Horizon? Personalised Screening Automated Breast Ultrasound
Contrast enhanced mammography Increasing role of MRI Artificial Intelligence image interpretation Minimally Invasive Breast Therapy
25
Asymptomatic No Clinical Findings Target Age Group
Population Based Screening Asymptomatic No Clinical Findings Target Age Group
Similar presentations
