Mobile digital breast screening: an evaluation of the Queensland experience

Abstract

This paper analyses some of the outcomes associated with the adoption of digital mammography in Breastscreen Queensland's mobile services to rural and remote parts of the state. A fleet of six mobile services, equipped with digital mammography equipment service these locations. Digital technologies, especially in spatially mobile screening venues, are seen to offer a number of advantages. First being able to immediately check the image quality to determine whether the image will suffice for screening purposes by a radiologist and can help reduce the number of client recalls due to technical issues. Secondly it has been suggested that digital mammography leads to enhanced job satisfaction on the part of radiographers, though the removal of the need to handle hazardous chemicals, and improved design of the mammography equipment. The digital technology is supported by a web based client information systems connected to BSQ databases through commercial 3G wireless services. The roll-out of digital breast screening technology only commenced in 2009 so the elapsed time between the introduction of the technology and our evaluation is relatively short. Therefore this paper focuses on outcomes that are already becoming apparent such as reduced rates of client recall due to technical issues with the images, while other benefits such as increased cancer detection rates will take time to accrue. The outcomes of the adoption of digital mammography in BreastScreen Queensland's mobile services are examined from the perspective of the client and the radiographer workforce. Using recent data we have found that for three mobile services, the technical recall rate drops to less than 1% following the introduction of digital mammography. This represents a decline in the technical recall rate of from 70% in one case to 100% in another. This decline in technical recall rates is greater than that which has hitherto been reported in the literature. Interviews and surveys of the BSQ workforce have shown that the digital mammography equipment was easier to operate and provides immediate "feedback" to the operator. This research found 95% of respondents (N=50) had high to very high job satisfaction, 73% indicated a high to very high reduction in physical workloads associated with digital technology, while 52% indicated that digital technology was either an important or very important factor in deciding to stay in their current jobs. Savings in the cost of client travel and time have been quantified, and significant difference between the amount of the costs savings were observed between services operating in different regions of Queensland.