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Introduction To report for the first time the image quality of mammograms performed in Papua New Guinea (PNG) using the Perfect, Good, Moderate, Inadequate (PGMI) image evaluation system (IES); and to benchmark the image quality against BreastScreen Australia (BSA) National Accreditation Standards (NAS). Methods A retrospective image quality analysis of the de‐identified mammograms of 102 women imaged at the Port Moresby General Hospital (PMGH) was undertaken using the PGMI IES. Each craniocaudal (CC) and mediolateral oblique (MLO) image was assigned a grade and the reasons for the grade recorded. Age was recorded in years. Simple frequency analysis was undertaken and comparison with BSA NAS 2.4 was made. Results Women were aged between 25 and 74 years. There were 111 CC views and 109 MLO views. The most frequent individual grade for the CC view was G (83.8%) and for the MLO view M (72.48%); and for a routine series (four images), P and G combined (14.8%). Non‐visualisation of the IMA (28%), nipple not in profile (26%) and short length of pectoral muscle (12%) were the most cited reasons for assigning an M grade. Conclusion The reported image quality is not commensurate with that required by BSA (P and G > 50%) and while common positioning errors can be rectified through education and training, it is also important to recognise the complex challenges faced by PNG radiographers in obtaining mammographic images that extend beyond education and training and reflect the emerging nature of the modality as well as wider health, economic and other issues. This work raises the need for national standards, dedicated equipment, and radiographer education to best serve the women of PNG.

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Introduction: Women with increased breast density are at increased risk of breast cancer. The aim of this research is to evidence for the first time the mammographic breast findings of Papua New Guinean (PNG) women and the relationship between Breast Imaging-Reporting and Data System (BI-RADS) assessment, mammographic parenchymal patterns (MPPs) and age. Methods: A retrospective analysis of 1357 mammograms of women imaged at the Pacific International Hospital (PIH) from August 2006 to July 2010 was undertaken. Mammographic findings were categorised using the BI-RADS Atlasâ 5th Edition. MPPs were recorded for each woman using the Tab ar Pattern I-V classification system. Age was recorded in years. Statistical analysis was by descriptive analysis and Kruskal-Wallis with Dunn's post-test and Spearman's rho correlation for inferential analysis. Results: True pathological findings (benign and malignant); BI-RADS 2-5 were noted in 111 women (8.2%); 1242 (91.5%) were negative. BI-RADS categories for malignancy were reported in 16 (88.9%) of women aged 30 to 60 years. The lower risk Tab ar Type I, II and III MPPs were associated with 94.4% (n = 17) of malignancies. Linear correlations between variables were weak and not statistically significant: age and Tab ar pattern r = 0.031, P = 0.0261; age and BI-RADS r = 0.018, P = 0.517; Tab ar pattern and BI-RADS r = 0.020, P = 0.459 (n = 1357). Conclusion: There was no correlation demonstrated between BI-RADS category, age and MPP. Importantly, there was no correlation demonstrated between BI-RADS categories 4 and 5 for breast malignancy and high-risk Tab ar Type IV and V MPPs. The results of this study again reflect that the incidence of breast cancer in PNG cannot be explained by breast density and suggest that any formalised screening program in PNG has a target age group aimed at women younger than that of Western screening programs.