M3.2019 Review mammography images for the presence of abnormalities and make recommendations for further action

Overview

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 to ensure that practice reflects up to date information and policies. Version No 2

Knowledge and Understanding

You will need to know and understand:

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 individual's 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

Performance Criteria

You must be able to do the following:

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

Additional Information

This National Occupational Standard was developed by Skills for Health. This standard links with the following dimension within the NHS Knowledge and Skills Framework (October 2004): Dimension: HWB6 Assessment and treatment planning