Even seemingly simple matters like lighting and dust can affect the quality of a mammogram picture. If light leaks around a door are a problem, for example, the mammogram may be fogged by extra light striking the X-ray film. Dust on the machine can falsely suggest cancer is present. The federal and state systems are set up so minor problems can be flagged before they become serious problems, said William Hack, a medical physicist who has inspected mammography machines for Michigan hospitals and medical facilities for 22 years. Mammography facilities must use medical physicists like him once a year to evaluate mammography machines and quality control programs.
Facilities are required to act on any findings or recommendations physicists consider important.
Newer machines do a good job of making automatic adjustments for each woman, he said. There aren't many clunkers out there, if any. You can't deliver a substandard mammogram and stay in business. Inspectors also check to see whether doctors reading mammograms are board-certified, which indicates whether they have passed national exams and participate in ongoing medical education. Technologists performing mammograms also must be nationally certified.