Mafraq Hospital, owned and operated by the Abu Dhabi Health Services Company PJSC (SEHA), recently performed an internal audit of their breast cancer screening programme. Despite breast cancer being the most common cancer in women in the UAE, there are few dedicated screening and diagnostic programmes here. Therefore Mafraq Hospital created a multi-faceted quality improvement programme for both the community and healthcare providers to promote screening awareness and provide high-quality subspecialised breast imaging care. The programme was headed by Dr. Rola Shaheen, Acting Chair of Radiology and Chief of Women’s Imaging, Department of Radiology. The retrospective review was undertaken to gauge the effectiveness of the programme since its implementation. Data collected during the period between March of 2012 and February of 2013 were compared to a control period, before the programme was implemented, between March of 2011 and February of 2012.
Results of the audit indicated very promising success. According to Dr. Rola Shaheen, “34 cancers were diagnosed among 182 tissue samples, yielding a positive tissue sample rate of 19%. Of these 34 cancers, two were detected by screening.” Compared to the period before the programme was initiated, more ultrasound-guided tissue collections were performed to screen for cancer, a technique better tolerated than others, which led to an increase from 9% to 19% in the number of cancer-positive tissue samples. Moreover, the rate of utilisation of breast imaging resources increased by 256% and there was a 343% increase in the number of image-guided tissue collections.
Mafraq Hospital implemented breast imaging under the guidance of standards published by the Health Authority of Abu Dhabi (HAAD). The launch of the imaging centre was accompanied by educational programmes, collaborative breast cancer initiatives, workshops, an international breast health lecture series, radiology-pathology correlation meetings, multidisciplinary tumour board conferences and community campaigns with mobile screening offerings from a van.
Implementation of a quality improvement breast health programme resulted in significantly increased utilisation of diagnostic breast imaging services by patients with breast symptoms, as well as improved breast cancer detection and diagnosis. Better screening methods have led to improved selection of patients for tissue sample collection and subsequent treatment. However, despite these successes, results of the audit indicated that there was no significant increase in the number of patients who sought breast cancer screening. Dr. Rola Shaheen explains, “This suggests that women in this region remain relatively unaware of the benefits of screening. Future efforts need to be devoted to identify and address these barriers to early detection of breast cancer in our community.”