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Importance of quality in breast cancer screening practice – a natural experiment in Alberta, Canada
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  • Published on:
    Quality in breast cancer screening: the breast positioning matters
    • Juliana P Guimães, Researcher & physician Hospital das Clínicas da Universidade Federal de Goiás - Goiânia, GO, Brasil.
    • Other Contributors:
      • Leonardo R Soares, Researcher & physician

    Dear editor,

    We read the article by Yuan et al. with great interest, which highlights different quality criteria in two breast cancer screening models in Canada (1).

    Currently, mammographic screening for breast cancer is recommended by several medical institutions and government agencies (2,3), based on prospective studies that have shown reduced mortality and other favorable outcomes (4,5). However, in recent years, several authors have questioned the benefits of population screening due to the rates of overdiagnosis and overtreatment (6). Nevertheless, many of these questions are based in retrospective and population-based studies, whose methodological limitations restrict the extrapolation of data to the individualized clinical context.

    The study conducted by Yuan et al. addresses an important issue of mammographic screening: the quality of the exams. Even in Canada, a high-income country with a consolidated health system, there are significant differences in the quality of screening between the centralized system (Screen Test, Alberta Cancer Agency) and community radiology clinics (1). Throughout the article, the authors also discuss several aspects related to technical criteria, such as cancer detection rate and false positive rate. However, as in most similar studies, nothing is discussed about the clinical quality control of the tests performed on both models.
    Clinical quality control involves several criteria related to breast positioni...

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    Conflict of Interest:
    None declared.