Mammography Quality Standards Act: Background and Issues Page: 1 of 6
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98-809 STM
Updated October 22, 1998Mammography Quality Standards Act:
Background and Issues
Judith A. Johnson
Specialist in Biomedical Policy
Science, Technology and Medicine DivisionSummary
Mammography uses X-rays to produce an image of the internal structure of the
breast. There is a long history of public and professional concern over the safety and
quality of mammography. Between 1985 and 1992, several studies found a wide range
in image quality and patient radiation dose. National, comprehensive quality standards
that applied to all mammography facilities were nonexistent until the Mammography
Quality Standards Act (MQSA) was enacted on October 27, 1992 (P.L. 102-539).
MQSA replaced the conflicting and overlapping patchwork of private voluntary
standards and limited state and federal regulations. H.R. 4382, which reauthorized
MQSA, was passed in September 1998 by the 105th Congress and signed into law by the
President on October 9, 1998 (P.L. 105-248). This report will be updated periodically.
Background
For American women, breast cancer is the most commonly diagnosed cancer and the
second leading cause of cancer mortality behind lung cancer. The American Cancer
Society estimates that in 1998, 178,700 new cases of breast cancer will be diagnosed and
43,500 women will die from the disease. Mammography can be used as a diagnostic tool
in women with symptoms or a screening tool in women without symptoms.
Mammography screening combined with clinical breast examination is currently the best
available method of breast cancer detection. Mammography uses X-rays to produce an
image of the internal structure of the breast and can often detect breast cancer when it is
very small, before it can be found by a woman or her physician.
In current practice, an X-ray technician, rather than a radiologist, performs the actual
mammography procedure. Breast imaging is not straightforward, and an accurate image
is among the most difficult to obtain for the X-ray technician; some technicians are better
at positioning than others. After the image is taken, a technician develops the X-ray film.
The radiologist reads the mammogram. Interpretation of a mammogram is not clear cut
either; abnormalities can be very subtle and other factors can affect clarity. For example,Congressional Research Service + The Library of Congress
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Mammography Quality Standards Act: Background and Issues, report, October 22, 1998; Washington D.C.. (https://digital.library.unt.edu/ark:/67531/metadc809126/m1/1/: accessed April 19, 2024), University of North Texas Libraries, UNT Digital Library, https://digital.library.unt.edu; crediting UNT Libraries Government Documents Department.