The National Health Service Breast Screening Programme in the Trent region—are we meeting the targets?

Aims In the UK National Breast Screening Programme, women aged 50–64 years are invited for breast screening mammography. This study aimed to determine whether current quality assurance guidelines for the Breast Screening Programme were being achieved. Method A prospective analysis of key outcome measures was performed in the 11 breast screening units in the Trent region, between 1 January 1995 and 31 December 1995. Results All 11 units exceeded the 70% target for screening attendance. Ten units matched the invasive cancer detection target for the prevalent screen, but this fell to three for the incident screen. Seven units achieved the 50% target for small invasive cancers, but for special type and well-differentiated cancers only three units matched the target of 30% and there was wide variation between units. Pre-operative diagnosis rates were short of targets in most units. Only one unit achieved outcome measures for clear histological margins in patients completing operations for breast-conserving surgery. No unit provided histological node status on all its patients undergoing surgery for operable breast cancer, or met the target for benign biopsy weights. Conclusion Although results as a whole are good, changes can be made to improve performance and reduce the variation between units. Particular attention should focus on those areas which can be influenced directly by surgeons.