Efetividade de programa de controle de qualidade em mamografia para o Sistema Único de Saúde

Abstract

OBJECTIVE:To assess the effectiveness of a quality control program in mammography services of the Brazilian National Health System (SUS). METHODS:A prospective study using temporal analysis of a health surveillance action was conducted. A total of 35 service providers that had mammography equipment in operation and regularly performed exams between 2007 and 2009 in the state of Goiás, Central-Western Brazil, participated in this study. Services were assessed during three site visits by performance testing of mammography equipment, fi lm processors, and other materials, and image quality and entrance surface dose in a phantom were also assessed. Each service was scored according to the percentage of tests that conformed to standards. RESULTS:The mean percentage for compliance among the participating service providers were 64.1% (13.3%) in the fi rst visit, 68.4% ( 15.9%) in the second, and 77.1% ( 13.3%) in the third (p < 0.001). The main improvements resulted from adjustments to the breast compression force, the automatic exposure control system, and the alignment of the compression paddle. The doses measured were within the conformity range in 80% of the services assessed. CONCLUSIONS:The implementation of this program in the mammography services was effective at improving the operational parameters of the mammography machines, although 40% of the services did not reach the acceptable level of 70%. This result indicates the need to continue this health surveillance action. DESCRIPTORS:

Performance of diagnostic centers in the classification of opportunistic screening mammograms from the Brazilian public health system (SUS)

“…In the present study, as the production of screening mammograms was analyzed, the authors observed that 44% of the mammograms were performed on patients in the age range between 40 and 49 years, 31.7% in the age range between 50 and 59 years, and 13.2% in the age range between 60 and 69 years. Such results demonstrate that the prevalence of mammograms is not coincident with the age group with highest breast cancer incidence, and that, like in other studies, the physician-patient relationship seems to be the most significant predictor for the performance of mammography (10,32,41,42) .…”

“…In 2010, 45 mammography apparatuses (32) were available for SUS in the state of Goiás. The present study allows inferring that one third of such apparatuses were installed in the Goiânia municipality.…”

Programa De Garantia De Qualidade Em Radiodagnóstico Médico

“…Em radiodiagnóstico, este programa visa garantir que as imagens médicas produzidas pelos equipamentos possuam qualidade suficiente para que traga o correto diagnóstico com o menor custo e dose possível para profissionais e pacientes, além de manter a instalação de acordo com legislações vigentes. [6] É possível observar que no setor de radiologia onde não existe um PGQ, existem alguns problemas organizacionais, tal como a repetição de exames, descarte excessivo de películas radiográficas, desperdício de materiais, perda de exames já realizados, demora no atendimento e que podem ser resolvidos a partir do desenvolvimento de um sistema de gestão de qualidade, envolvendo toda a organização [7], o que inclusive é atribuído como de extrema importância por parte dos profissionais, de forma que a padronização de rotina e como ferramenta útil para facilitar o decorrer do exercício da função [8].…”

Evolution of mammographic image quality in the state of Rio de Janeiro

“…Considering the academic and clinical consensus about mammography being the imaging method of choice for breast cancer screening ( 5 ) , it is expected that such a procedure produces good-quality images with the use of the lowest possible radiation dose. In Brazil, the initiatives aimed at mammography quality assurance started in 1991, with the Mammography Quality Control Program implemented by Colégio Brasileiro de Radiologia, whose adhesion was voluntary ( 6 , 7 ) . In the same decade, the Federal Ordinance 453/98 established the guidelines for protection in medical and odontological radiodiagnosis ( 6 , 8 , 9 ) .…”