Department of Radiology, Seoul National University Hospital
In Korea, national cancer screening program （NCSP） began in 1999 for five major cancers, including stomach, breast, uterine cervix, liver and colorectal cancers. The NCSP recommends biennial breast cancer screening for females over 40 years of age with mammogram ± clinical breast examination as the screening tool. The Korean Society of Breast Imaging （KSBI） developed guidelines and standards of quality management for mammography from 1999. On January 14, 2003, the national assembly of Korea approved the Acts including quality management for mammography. Annual inspection includes the facilities to meet minimum quality standards for personnel, equipment, and phantom image. Every three year, on site survey and evaluation of clinical image are added. Mammography accreditation program has been helping facilities improve the image quality by peer review and professional feedback. Breast Cancer Screening Guideline in Korea has been revised in 2015 but ultrasound was not included. KSBI developed guidelines and standards of breast ultrasound practice in 2011 and includes the facilities to meet minimum quality standards for personnel, equipment, and phantom image. In Korea, performance of screening mammography was associated with sensitivity of 85.0-91.5％, specificity of 95.0-99.0％, PPV1 of 0.8-2.5％, PPV2 of 18.0-27.7％, recall rates of 5.1-13.0％, and cancer detection rates of 0.5-2.0/1000. Compared with the ideal goal of ACR in USA, PPV1 and cancer detection rates are lower than the goal of ACR. It is probably due to lower cancer incidence in Korea than that of USA. In the near future, results of 10 year performance and outcome measurements of NCSP in Korea will be reported. We evaluated the characteristics of US-detected breast cancer in the screened women compared with mammography-detected cancer. The survival outcome as well as clinical, pathological and immunohistochemical data of these patients will be presented.