Quality assurance sessions have limited impact on cancer detection, but help educate technologists

Readings performed between technologists and radiologists during quality assurance sessions identify few additional cancers, but can help imaging professionals develop their interpretation abilities.

In the Netherlands, technologists attend a quality assurance session every six weeks, discussing mammography exams and recall rates with coordinating radiologists. All breast exams are previously classified according to the Breast Imaging and Reporting Data System and double-read by radiologists.

Angela M. P. Coolen, with Elisabeth-Tweesteden Hospital, and colleagues wanted to know what kind of additional breast cancers are detected and if these meetings are in fact beneficial.

To do so, they performed a secondary analysis of mammograms from more than 14,000 women who were recalled between January 2009 and 2017. Coolen and colleagues found 3,156 screening-detected cancers, of which 26 (0.8%) were detected through quality assurance sessions. Most of these were invasive tumors (17%) and larger than 10 millimeters.

And only 3.4% of proven cancer cases had a positive screening performed by a technologist for the same breast abnormality in a prior round of cancer screening.

“This suggests that technologist readings provide insufficient discriminating ability in deciding which negative screenings at radiologist double reading are eligible for secondary referral,” the researchers wrote. “The role of quality assurance sessions in additional cancer detection is limited,” they added.

This doesn’t mean the meetings are completely useless, however. They serve many other purposes, the authors noted, included further training for technologists, the ability to discuss instructive cases and performance feedback from peers.

The full study was published Jan. 7 in Radiology.