Trends in Attaining Mammography Quality Benchmarks With Repeated Participation in a Quality Measurement Program: Going Beyond the Mammography Quality Standards Act to Address Breast Cancer Disparities

Abstract

Purpose: The Mammography Quality Standards Act requires that mammography facilities conduct audits, but there are no specifications on the metrics to be measured. In a previous mammography quality improvement project, the authors examined whether breast cancer screening facilities could collect the data necessary to show that they met certain quality benchmarks. Here the authors present trends from the first 5 years of data collection to examine whether continued participation in this quality improvement program was associated with an increase in the number of benchmarks met for breast cancer screening.

Methods: Participating facilities across the state of Illinois (n = 114) with at least two time points of data collected (2006, 2009, 2010, 2011, and/or 2013) were included. Facilities provided aggregate data on screening mammographic examinations and corresponding diagnostic follow-up information, which was used to estimate 13 measures and corresponding benchmarks for patient tracking, callback, cancer detection, loss to follow-up, and timeliness of care.

Results: The number of facilities able to show that they met specific benchmarks increased with length of participation for many but not all measures. Trends toward meeting more benchmarks were apparent for cancer detection, timely imaging, not lost at biopsy, known minimal status (P < .01 for all), and proportion of screening-detected cancers that were minimal and early stage (P < .001 for both).

Conclusions: Participation in the quality improvement program seemed to lead to improvements in patient tracking, callback and detection, and timeliness benchmarks.

Keywords: Breast Cancer; Mammography; Mammography Quality Standards Act; Quality Improvement.

Figure 1.

Change in the number of facilities meeting 12 specific benchmarks. Benchmark for known stage at diagnosis not shown (data are in Table 4). Solid lines represent changes in the proportion of of facilities meeting a specific benchmark depending on the number of available time-points for analysis (2,3,4, or 5). The dashed line represents the linear trend in the proportion of of facilities meeting the benchmark over time using all available information. P-values>0.15 are suppressed. Chicago Breast Cancer Quality Consortium (2006-2013).