Improving early detection of breast cancer
The University of Sydney in partnership with BreastScreen NSW and Ziltron, has developed a pioneering web-based programme to monitor the performance of radiologists in detecting and diagnosing abnormalities in breast x-rays.
Currently commencing its nationwide rollout, the BREAST Project has the
potential to improve the early detection of breast cancer through
screening and in turn reduce breast cancer mortality and
morbidity.
About 1.6 million women have mammograms each year in Australia,
however, reading mammograms is one of the most challenging tasks in
radiology according to Program Co-Director, Professor Patrick
Brennan from the University of Sydney's Faculty of
Health Sciences.
BreastScreen Australia aims to maximise the number of breast
cancers diagnosed early, enabling early treatment and improving
outcomes for women. Key to this is providing feedback and support
to image readers.
'The project supports this through increasing the opportunity
for radiologists to monitor their performance and receive feedback
following examination of series of test cases', says Professor
Brennan.
The BreastScreen Reader Assessment Strategy (BREAST) is based on
a world-first web-based programme of digital screen-reading test
sets designed to assess the performance of the user in correctly
identifying abnormalities on mammograms and in interpreting whether
or not the lesions identified pose a risk of breast cancer.
"The strength of the project is the comprehensive collection of
breast x-rays which form the test sets," says Prof Brennan. "They
have been developed in partnership with BreastScreen NSW and
thoroughly validated through subsequent scans and biopsy."
The BREAST Project will benefit all BreastScreen Australia
services, which offer screening at more than 500 locations
Australia wide. The Ziltron web-based system with its unique
embedded algorithm allows for the provision of real-time and
instant evaluation and feedback to participating radiologists and
will also enable the development of national performance standards
based on confidential data collection.
"This will allow us to determine the level of variation across
BreastScreen Australia, set reference levels for good performance
and encourage targeted quality improvement programs to manage under
performance," says Warwick Lee, State Radiologist for BreastScreen NSW, Adjunct
Associate Professor at the University of Sydney and Co-Director of
BREAST.
"The data collection - made possible through our technology
partnership with Dr. John Ryan and Ziltron - also presents immense
opportunities for further research into the types of lesions that
are creating difficulties for readers, either through
underdiagnosis or overdiagnosis, and has huge potential for
improving standards in the future," comments Prof Brennan.
Dr John Ryan, CEO of Ziltron, a global company specializing in
the field of real-time web-based performance-analysis systems, said
the joint venture puts Australia at the forefront of this
field.
"By implementing our system as a breast-screening quality and
performance tool, Australia is proving to be the most innovative
and progressive nation in this field."
The Department of Health and Ageing has funded the development
and nationwide implementation of the BREAST Project, building on
the pilot funding provided by the Royal Australian and New Zealand
College of Radiologists (RANZCR). Radiologists volunteer to take
part in the Project which is recognised by RANZCR as continuing
professional development contributing to reaccreditation.
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