Digital breast screening initiative set to save lives

A new self-assessment and training scheme designed to increase the accuracy of mammogram interpretation has put a local hospital in the running for a regional innovation award.

The Digital PERFORMS scheme, a collaboration between Royal Derby Hospital and Loughborough University, has been shortlisted in the ‘Innovation Achieved’ category for the 2010 Lord Stafford Awards after impressing the judging panel.

In the UK, breast screening for all women aged 50 and over currently takes place every 3 years.  Within this age range the incidence of breast cancer is very low - only 4.2% of women are recalled for further assessments and some of these will be for benign conditions.  Each year almost 2 million women are screened and their mammograms are examined by nearly 700 screening personnel, consultant radiologists and advanced practitioner radiographers, for very early signs of abnormalities. 

As breast cancer is rare all screeners must examine at least 5,000 cases a year so as to maintain their experience of a wide range of mammographic appearances. Additionally, all screeners take part in the PERFORMS scheme which was founded in 1988 to implement twice annual self- assessments, with screeners examining recent difficult cases.  This scheme enables all screeners to experience in a short period of time a very wide range of difficult normal, benign and malignant mammogram appearances thereby helping them to detect very early signs of cancer.

The digital PERFORMS scheme is an update of the original concept, utilising high resolution computer screens to enhance the detail of mammogram images.  Moving into digital imaging also allows additional training to be made available on-demand, whatever the location of the trainee.   For instance, the scheme has already shown that office computer screens are viable platforms for some training purposes and ongoing work is investigating the use of other mobile devices, such as the iPad, to make training truly accessible.

The University team has developed the original PERFORMS scheme over some 20 years, using mammographic films.  Working alone however, it has been unable to change to using digital mammographic images. Derby is a pioneer of digital breast screening in the UK and so working with the Royal Derby Hospital the project has benefitted from cutting edge state-of-the-art health informatics.

Dr Anne Turnbull, Breast Screening Director at the hospital, said:   “We are delighted to have been selected for the Lord Stafford Awards finals; the shortlisting is wonderful recognition of the continued hard work put in by ourselves and the university throughout our transition to digital imaging.” 

The joint relationship has also helped the university strengthen its links with NHS Cancer Screening Programmes and enhanced its standing with respected professional bodies such as the Royal College of Radiologists.  This has aided efforts to secure further research funding, culminating in £1.2m over four years from 2009 which has secured the futures of specialist staff within the university over that term as Alastair Gale, Professor of Applied Vision Sciences and inventor of PERFORMS, explains:

“The University has benefitted hugely from contributing to the health of all women in the UK and the PERFORMS project has led directly to both research funding and other new grant applications in related research fields.”

 “Partnering the Royal Derby Hospital has meant that the project can change rapidly to using digital images, enabling us to offer state of the art assessment and training in breast screening.”

The Digital PERFORMS scheme has wide ranging possible applications and the potential to make a major global impact in the battle against cancer.  A version is being developed to be used internationally following considerable overseas interest.   Additionally, plans are in place to adapt the technology for use in other cancer areas such as bowel and colon cancer screening.

Outside the healthcare sector, this unique multi-disciplinary expertise has the potential to be translated into the increasingly important area of airport security, ensuring high standards in the screening of passenger luggage X-ray images searching for potential terrorist threats.

The winners of the awards, which cover ‘Innovation Achieved’, ‘Innovation in Development’ and ‘Innovation for Sustainability’, will be announced at a high-profile finale on September 9^th at Athena in Leicester.

Sponsors for the event include the East Midlands Development Agency, the East Midlands Universities Association, CFE, Connect Midlands, epm: technology ltd, Swindell and Pearson, Leicester and Leicestershire Leadership Group and the Enterprise Europe Network.

For further information, visit www.thelordstaffordawards.co.uk