Comparison of image quality between mammograms performed by an assistant practitioner and by screening radiographers

Bolton is one of the four national development sites for skill mix in the UK National Health Service Breast Screening Programme. Two assistant practitioners have been trained in-house to perform mammography; one (AET) commenced training in September 2000, and the other in April 2001. AET has now been performing mammography under indirect supervision for several months.

Fifty mammographic examinations performed recently by AET and 50 performed by radiographers with the Certificate of Competence in Mammography were randomly selected. All 100 examinations were performed in the same screening unit over the same period of time. Examinations on 'difficult' women (e.g. in a wheelchair) were excluded as these would not be performed by an assistant practitioner. The examinations were randomly mixed and the mammographers' identifiers on the films obscured. The oblique views were assessed by an experienced radiographer (DS) using a simple satisfactory/unsatisfactory scoring system for each of nine variables.

The images produced by the assistant practitioner were slightly less likely to be symmetrical, but otherwise there was no significant difference in the quality of the images produced by the assistant practitioner compared with those produced by the radiographers. The findings confirm that assistant practitioners can make a valuable contribution to the Breast Screening Programme.