In the USA, mammography is highly regulated under the MQSA (Mammography Standards Quality Act). Congress enacted MQSA in 1997, to ensure that all women have access to quality mammography for the detection of breast cancer in its earliest, most treatable stage.
This ensures mandatory minimum standards and accreditation of both equipment and staff
- Equipment has to be accredited each year
- Typical examinations for each breast type have to be submitted by the hospital
- Reporting mammographers have to meet a minimum number of examinations per year
As part of accreditation of mammography units (we were just commissioning a new Hologic Selenia in our screening pavillion), all 'attendings' reporting digital mammograms require 8 hours of training/background knowledge, to legally report digital mammograms. This is checked by the FDA inspectors whose job is to insure compliance with the 'Act'.
Part of the training can be with an applications specialist, enabling you to get the most from your workstation, and how to use (and not abuse) your digital workstations. We were running a breast imaging update course in San Francisco last weekend, and covered Digital Mammography with 4.5 hours of AMA accredited CME, covering all aspects of Digital, including medico-legal aspects, pitfalls in reporting, IHE applied to FFDM, review of the trials and recent reviews, the use of CAD etc.
Some of the issues of working in a mixed environment (due to economic constraints) we are encountering every day, as we work with a mix of analogue, FUJI CR and Hologic FFDM. Our workstations are Selenia's but do not display the FUJI images as intended, which is where IHE is supposed to come in and ensure that images can be displayed, independent of vendor.