Review mammography images for the presence of abnormalities and make recommendations for further action

This standard is about the visual inspection of mammography images to identify areas of possible abnormality. This inspection, and all other relevant information that may be available, will be used by the practitioner to make a decision whether to recall the individual for further investigations. This standard applies to the interpretation of radiographic images obtained of the breast as part of a regular screening or symptomatic programme. Users of this standard will need

1. check the identification of images against associated documents

   2. review all the information recorded at the time of mammography

   3. examine the images for technical and diagnostic quality

   4. examine the images under appropriate conditions using

   appropriate visual enhancements

   5. examine in detail the total area of all images

   6. compare previous mammograms with current images for any

   significant change

   7. review all the evidence available from visual examination of the

   current mammogram, previous mammograms and from the

   documented history

   8. examine areas perceived as abnormal to determine their nature

   and record your assessment according to local protocol

   9. recognise where help or advice is required and obtain this from

   appropriate sources

   10. compare the results of any additional reader(s) and take

   appropriate action according to local protocols

   11. decide whether or not to recall the individual and take action

   according to local protocols

   12. ensure that where individuals are recalled, appropriate

   imaging/diagnostic procedures are identified in accordance with

   local protocols and national guidelines

1. legal, organisational and policy requirements relevant to your role,

   the role of others in your organisation and the activities being

   carried out

   2. the relevant national and local standards, guidelines, policies and

   procedures that are available and how and when they should be

   accessed

   3. the limitations of your own knowledge and experience and the

   importance of operating within your scope of practice

   4. the purpose of the breast diagnostic and screening services

   5. the quality assurance programmes in symptomatic, assessment

   and breast screening services

   6. radiation physics and x-ray imaging

   7. the criteria for technical acceptability of mammograms

   8. the need to optimise the radiation dose received by individuals

   9. the technical features of mammographic images, the imaging

   process and optimal viewing conditions

   10. the anatomy, physiology and pathology of the breast, axilla,

   subcutaneous tissues and associated structures

   11. the individuals medical history where available

   12. the mammographic manifestations of breast disease and normal

   variations as a result of age, hormonal state, surgery and

   radiotherapy

   13. identification and orientation markers

   14. the areas of the breast particularly at risk of developing abnormal

   appearances or where cancer detection may be difficult

   15. the clinical findings associated with normal, benign and malignant

   tissue

   16. the interdependency and significance of recorded information and

   mammographic appearance

   17. how to obtain previous records and images

   18. the reasons for comparison with previous mammograms and the

   significance of the changes which may have occurred

   19. decision making strategies and categorisation of risk of

   malignancy

   20. how to keep full, accurate and clear records in line with

   organisational procedures

This standard links with the following dimension within the NHS

Knowledge and Skills Framework (October 2004):

Dimension: HWB6 Assessment and treatment planning