An evaluation of the present status of quality assurance program implementation in digital mammography facilities in a developing country

Quality assurance program (QAP) implementation in mammography is a key aspect to guarantee the acquisition of -quality images and, thus, an opportune diagnosis of breast cancer. A QAP involves planned and systematic actions, such as quality control (QC) tests that will produce consistently high-quality images, while considering low radiation exposure for stakeholders. Currently, there is poor evidence of the current QAP implementation status in developing countries, particularly in Latin America. In this work, 47 Mexican digital mammography facilities were evaluated in terms of their QAP implementation's current status during the period October 2021 to April 2022. A survey of three key indicators of compliance/non-compliance with QAPs was carried out. Also, 17 QC test parameters were assessed in all mammography units according to an international framework. The Kruskal-Wallis test, McNemar test, and Spearman correlation were used to identify the significant correlation between the QC tests and QAP indicators. Statistical analysis showed a significant positive correlation between the QAP indicators and QC parameters that were evaluated, especially associated with an increase in image quality. Almost 90% of the facilities evaluated failed in some QAP indicators, and only 44.68% of the facilities had an updated and current QAP implemented. Successful QAP implementation directly impacted on the QC mammography test results, particularly in terms of image quality, thus conditioning a successful mammography acquisition chain. The results obtained in this work suggest that better regulations need to be implemented to guarantee QAP surveillance, which could mean an increase in opportune diagnosis and management of breast cancer, with improved radiological safety for patients and occupational exposure personnel.