Flaw in breast screen reports

A computer glitch that forced the re-reading of over 5000 mammograms in Victoria may prompt other states to review breast screening quality control, the Federal Health Department says. 

The Victorian software problem is the first known hitch in the program after the move to digital mammography in all states and territories. 

BreastScreen Victoria has launched an investigation, meanwhile, writing to 5339 women to explain that their mammographic screens may not have been reviewed by two independent radiologists in accordance with best practice.

CEO Vicki Pridmore said the issue was flagged by a radiologist and appeared to be confined to a period in September-October this year.

“For a while we thought it was just one instance and then we started to investigate, and there were a handful of instances (so) I said we need to go back and triple-check that everybody has had their images read twice,” Ms Pridmore said.

A spokeswoman for the Federal Health Department said BreastScreen Australia National Accreditation Standards require   screening images be examined by two independent readers.

While all jurisdictions had mechanisms in place to ensure the quality of their services,  she said the Victorian issue may prompt these to be reviewed.

Ms Pridmore said she had informed each state and territory about the glitch, although software used varied among jurisdictions, and the incident would be discussed at a routine national meeting in December.

Software had now been installed in Victoria to ensure the problem, which relates to the interface between the radiologists’ work list and the picture archiving system, does not recur.

The affected women have been assured they will have their images reviewed before Christmas.

The likelihood of any cancers being missed was tiny, with the overall cancer detection rate being less than 0.5%, Ms Pridmore said.

“I know a lot of people would say this [response] is overkill, but that independent two-reads is really one of the cornerstones of the BreastScreen program,” she said.

While there have been concerns about a shortfall in breast screen-accredited radiologists, Ms Pridmore said technology factors rather than workforce issues were at fault in this case. 

Meanwhile, UK experts have advocated yearly mammograms for women aged 40-49 years who have a medium   risk of breast cancer. These women have a family history sufficient to increase their risk above the general population, but not enough to raise serious suspicion of a high-risk gene mutation.

Their analysis suggested that 10,000 screening events in this group would prevent two deaths from breast cancer within 10 years of diagnosis.

Lancet Oncology, online