The future of breast radiography: European perspective

Digital technology has entered the practice of mammography. In the coming years, digital mammography will be gradually implemented in most European countries and will change the practice of mammography also from the radiographer's perspective. A computed radiography system is a quick simple conversion from analogue to digital; there is little change in workflow, whereas the introduction of full field digital mammography systems using direct radiography detectors implies a significant change. The X-ray film is replaced by solid-state detectors that convert X-rays into electrical signals, producing images that can be studied instantly on a computer screen. Thus, there are no cassettes, no markers, no bucky to change, no darkroom, no waiting to check films, and no viewboxes. Digital mammography provides higher resolution, which may improve detection, but it also pronounces folds and wrinkles, due to less optimal positioning.

Considering the professional status of the radiographer, we encounter major differences in the various European countries. On the one hand, in some countries, screening radiographers are involved in film-reading and diagnostic procedures. On the other hand, the radiographer might just be the one pressing the button. Breast centres should employ well-trained specialized breast radiographers, as full members of the multidisciplinary team. They should be involved in the minimal invasive biopsy, ultrasound and magnetic resonance imaging techniques, as well as in upcoming new techniques, such as tomosynthesis, automated three-dimensional breast ultrasound, dual-energy contrast enhanced mammography, and so forth.