Physical and technical aspects of quality assurance in mammography in the Republic of Srpska

Breast cancer is the most frequent malignant neoplasm affecting the female population. In order to reduce its morbidity and mortality rate, a mammography screening campaign has been established in both entities of Bosnia and Herzegovina. In this paper, a brief survey is given on the mammography screening practice in the Republic of Srpska. As an illustration, results of measurements of technical parameters, including mean glandular dose, for 31 mammography units are presented. Large fluctuations in dose among different measuring sites were found, unacceptable not only from the standpoint of mammography screening, but in clinical mammography as a whole. Subsequently, a series of quality control tests and corrective measures throughout the mammography imaging chain are proposed, in line with international guidelines and newly promulgated national legislation. Dose optimization and image quality improvement are the first and foremost goals to be achieved in order to setup a successful mammography screening program