Addressing Increased Demand: Outsourcing Mammography Readings

Faced with escalating demand for its breast cancer early detection program, the Ministry of Health of Castilla y León is set to reintroduce external services for double reading and reporting of mammograms. This strategic move aims to maintain diagnostic speed and quality amidst a growing workload.

The decision comes as the screening program expanded in late 2023 to include women up to 74 years of age, significantly increasing the number of annual mammograms to over 122,000. The new tender, valued at €1.38 million for the initial year, includes a possible two-year extension, perhaps raising the total investment to over €3 million. Funding is allocated across two years,with €929,200 earmarked for 2025 and €450,800 for 2026.

The Backbone of the Program: Double Reading and Quality Assurance

Since its inception in 1992, the program has relied on a double independent reading system, where two radiologists independently assess each mammogram. This method enhances diagnostic accuracy but also increases the workload. Last year, nearly €4 million was allocated to this crucial service, highlighting its importance in the region’s healthcare strategy.

AI integration: A Technological Leap Forward

In a parallel effort to enhance efficiency and precision, the Board is actively implementing an artificial intelligence (AI)-assisted reading system, expected to be operational by December. This initiative represents a notable investment of €1.32 million, financed by European Union NextGeneration EU funds.The AI software is designed to reduce turnaround times, prioritize suspicious cases, and improve overall accuracy through CE-marked algorithms.

AI offers the potential to revolutionize medical imaging analysis, providing faster and more accurate results.
Dr. Elena Ramirez, Head of Radiology, University Hospital of León

The integration of AI into breast cancer screening aligns with global trends in healthcare, where technology is increasingly used to augment the capabilities of medical professionals.For example, studies have shown that AI can improve the detection rate of breast cancer by up to 5% when used in conjunction with radiologists.

Ensuring Equitable Access: Mobile Mammography Units

The autonomous detection program extends its reach to all health areas, including rural and remote regions, through a mobile mammographic unit. This unit ensures territorial equity, especially in municipalities without hospitals. The service is currently undergoing renewal, with a budget of €844,920 allocated between 2025 and 2028.

equipped with advanced technology such as volosynthesis (3D mammography) and synthesized imaging, the mobile unit caters to complex cases and women with dense breasts. Annually, it performs approximately 11,735 mammograms, serving a rural population of over 33,500 women.

2023 Screening Results: Key Data and Regional Variations

Data from 2023 reveals that 122,193 mammograms were performed, with 7,503 (6.14%) yielding suspicious results and requiring further hospital care. Derivation rates varied across the region, ranging from 3.7% in Zamora to 9.9% in Soria.

Understanding breast Cancer Incidence in Castilla y León

In Castilla y León, breast cancer typically manifests between the ages of 35 and 80, with a higher incidence in the 45 to 65 age group. It’s significant to note that the risk of breast cancer increases with age, underscoring the importance of regular screening for women in these age brackets.