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Review Article | DOI: https://doi.org/10.31579/2690-1919/548
1 Department of Pharmacy, Vignan Pharmacy College, Vadlamudi, Guntur, Andhra Pradesh, India.
2 Department of Regulatory affairs, Shri Vishnu College of Pharmacy, Bhimavaram, West Godavari (Dt), Andhra Pradesh, India.
*Corresponding Author: N.L Prasanthim, Pharm, PhD Professor, HOD, Department of Regulatory affairs, Shri Vishnu College of Pharmacy, Bhimavaram, West Godavari (Dt), Andhra Pradesh, India.
Citation: Sarvan M. Seethamraju, K. Venkateswara Raju, G. Dhamasri, Lakshmi P. Nori, (2025), Current Scenario and Regulatory Issues of Mammography- A Magic Tool for Women’s Health, J Clinical Research and Reports, 20(3); DOI:10.31579/2690-1919/548
Copyright: © 2025, N.L Prasanthim. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 16 June 2025 | Accepted: 02 July 2025 | Published: 09 July 2025
Keywords: breast cancer; mammograms; mortality; 3d image; tomosynthesis
The most frequent kind of cancer in women over 40 is breast cancer. According to studies, the likelihood of surviving breast cancer is considerably increased by early identification and adequate treatment. Additionally, they have demonstrated how early diagnosis of tiny lesions improves prognosis and significantly lowers mortality. In this situation, mammography is the most effective diagnostic method for screening. However, due to minute variations in the densities of various tissues in the breasts with thick tissues, mammography interpretation is challenging. This study examines the automated mammogram image analysis for breast cancer early detection. If it is identified early, this research might provide radiologists with a greater understanding of preconceptions and offer a better prediction, leading to a considerable drop in mortality of women with breast cancer.
Mammogram is the most effective technique for women to detect breast cancer early, when it is less difficult to treat and before it has grown large enough to feel or produce symptoms. “Regular mammograms can reduce the likelihood of dying from breast cancer. For the majority of women who are screening age, a mammography is now the best method of detecting breast cancer [1]. An X-ray of the breast is used in mammography to detect cancerous alterations. It is utilized as a screening test for asymptomatic women as well as a diagnostic tool to check sick women. The purpose of screening mammography is to find breast cancer early, before a breast lump is felt, while assuring consistently excellent mammography results and exposing the women to radiation as little as possible. The success of mammography screening depends on having a population-based screening programme that achieves high screening coverage of women in the at-risk age group, as well as on the quality performance of the technology.” Women who are detected with abnormal results are then diagnosed and treated. “In 2014, the most recent year for which data is available, the Centers for Disease Control and Prevention (CDC) reports that over 235,000 women had breast cancer diagnoses, and more than 41,000 of them passed away from the condition. In 2017, it was predicted by the National Cancer Institute of the National Institutes of Health that over 250,000 women will be diagnosed with breast cancer and over 40,000 of them would pass away from the condition. As the second biggest cause of cancer deaths among women after lung cancer, breast cancer is now the most prevalent non-skin cancer.” The best way to avoid deaths that may occur if the diagnosis is postponed until the start of more severe symptoms is early diagnosis of breast cancer, which commonly involves breast physical examination and mammography. X-rays are used in mammography, a form of medical imaging, to create images (mammograms) of the internal breast tissues. Screen-film mammography, full-field digital mammography, and digital breast tomosynthesis are all terminology that are used interchangeably in this text. By directing x-rays through the breast, screen-film mammography exposes an x-ray film sheet that is stored in a cassette. The x-rays travel via an image receptor, an electronic component or plate that is radiation-sensitive, during full field digital mammography. Images can be digitally enlarged and shown on a computer workstation, for instance. A computer workstation and an electronic image receptor are used in digital breast tomosynthesis to gather several images of the breast taken from various perspectives. Then a sequence of parallel pictures that resemble breast slices are created on a computer. Mammography can detect breast cancer in its earliest, by detecting with any other method. The interpreter could overlook a malignant lesion if the image quality is subpar. An unnecessary death or increased morbidity could occur as a result of such a false negative diagnosis that delays treatment. It is also true that when normal tissue is mistakenly identified as abnormal due to subpar photos or incorrect interpretations, a false positive diagnosis may result. This could result in unneeded stress for the patient, expensive extra testing, and unnecessary biopsies2.The Comparison of mammography and tomosynthesis is given in the Figure 1.
Figure 1: Comparison of mammography and tomosynthesis
History of Mammography
Normal X-ray equipment was used to create the first mammogram in 1913 by Berlin surgeon Albert Salomon on an axilla and breast that had been surgically removed. Dr. Salomon sought to demonstrate how the breast cancer had migrated to the axillary lymph nodes. “Dr. Salomon's study was unfortunately cut short by political upheaval in Germany, and it wasn't until 1927 that another German surgeon, Otto Kleinschmidt, revealed a technique for imaging the breast that he ascribed to his mentor, the cosmetic surgeon Dr. Erwyn Payr. In 1931, Walter Vogel and Paul Seabold made the first discoveries on how to distinguish benign from malignant tumors on a mammogram. Shortly after, in 1938, radiologists Jacob Gershon-Cohen and Albert Strickland wrote a paper documenting the radiographic changes in a woman's breast throughout the course of her menstrual cycle and life. In an effort to convince his colleagues of the importance of mammography, Dr. Gershon-Cohen often contrasted pathological samples with mammographic pictures throughout his career. By using two films to capture data from both the thinner peripheral breast and the denser posterior breast tissue, Dr. Gerson-Cohen emphasized the importance of image contrast and compression3. Despite his efforts, mammography was not widely used until the 1950s. In 1949, Raul Leborgne of Uruguay reported using mammography to discover micro calcifications in 30% of breast cancers.” As a result, interest in mammograms was revived. Leborgne, who created the modern mammogram, stressed the importance of adequate compression and spot/magnification to more clearly show minute structures. He laid the foundation for our current methods with his huge cone-shaped compression devices, meticulous placement instructions, and calibration for exposure times. But Robert Egan was the one who brought all the technologies together. In the early 1960s, he effectively standardized screening mammography by using high mill ampere, low-kilovolt x-rays on grid-covered industrial film. The first national mammography study, which encompassed 24 institutions, was presented at a symposium on mammography by the US Department of Public Health's Cancer Control Programme in May 1963 at M.D. Anderson Hospital. The results shown in the Egan’s method screening trail gave 21 Percent sign false-negative rate and a 79 Percent sign true-positive rate. This was a turning point in how American women were seen. Mammography screening had a challenging beginning. Leborgne's initial poses, in which the lady was lying on her side, have been replaced with Egan's posture, in which the woman is standing [4].
Outlook of breast cancer
Breast cancer is a disorder when the cells in the breast proliferate uncontrollably. There are various types of breast cancer, each of which is caused by breast cells turning cancerous. Breast cancer may develop in a variety of breast tissues. Figure 2 shows the three essential parts of a breast.
Figure 2: Diagram of the breast
The glands that generate milk are called lobules. The milk ducts that lead to the nipple are known as. The connective tissue, made up of fatty and fibrous tissue, surrounds and holds everything in place. The lobules or ducts are where most breast cancers begin. Breast cancer treatment can be quite effective, especially if the illness is caught early. Breast cancer is commonly treated with a combination of surgical surgery, radiation therapy, and medication (hormonal therapy, chemotherapy, and/or targeted biological therapy) in order to cure the microscopic cancer that has spread from the breast tumor through the blood.Such therapy can halt the development and spread of cancer, therefore saving lives [5].
Overview of the problem
In 2020, 2.3 million women worldwide lost their lives to breast cancer, which claimed around 6,85,000 lives. Breast cancer, which had been discovered in 7.8 million women over the preceding five years, was the most prevalent disease in the world as of the year 2020. Breast cancer is the form of cancer that results in the most lost disability-adjusted life years (DALYs) for women globally. Although the incidence rates increase as people become older, breast cancer affects women after puberty in every place on earth. The death rate for breast cancer did not vary from the 1930s to the 1970s. Improvements in survival began in the 1980s in countries with early detection programmes and various sorts of therapy to get rid of invasive illness. Some indicators of breast cancer include a newly discovered lump in the breast or armpit, Swelling or thickening of a portion of the breast, Dimpling or irritation of the breast skin, Redness or dry skin around the breast or nipple, Nipple pulling in or soreness in the nipple region, Nipple discharge, such as blood, that is not breast milk, Any modification to the breast's size or form and pain in any breast region. Breast cancer can be found and diagnosed using a variety of tests. Such as mammograms, breast ultrasound, breast MRI and newer and experimental breast imaging test [6]. Distribution of breast cancer cases and deaths by world area in 2020 is shown in Figure 3.
Figure 3: Distribution and death related breast cancer cases world area in 2020
Mammography techniques and technologies
3D mammography -Before being commercialized in the United States, new breast imaging equipment must first get FDA approval, clearance, or permission. Digital breast tomosynthesis sophisticated mammography machines that can generate numerous cross-sectional pictures of the breast from X-rays obtained from various angles have been approved by the FDA. These tools offer useful breast tissue images and could be useful for assessing dense breast tissue [7]. Breast tomosynthesis and digital breast tomosynthesis (DBT) are other names for three-dimensional (3D) mammography. Each breast is crushed from two separate angles (once from top to bottom and once from side to side) similar to a conventional (2D) mammography while x-rays are being collected. However, during a 3D mammography, the machine moves in a tiny arc around the breast while taking numerous low-dose x-rays. The photos are then combined by a computer into a series of thin slices. Doctors can now more clearly and in three dimensions observe the breast tissues thanks to this.
Digital Mammography - Breast cancer screening was initially carried out using screen-film mammography. With the development and launch of affordable large-area digital detectors in the early 2000s, digital mammography was created and made available for clinical usage. In Digital mammography, the usage of film was swapped out with a digital x-ray detector, which produced an image digitally right away, ready for the acquiring radiographer to assess for suitability and the radiologist to interpret. Than screen-film mammography the DM has a number of advantages, with the workflow being one of the most straightforward. The development of more sophisticated image acquisition techniques, such as DBT and dedicated breast CT, as well as the introduction of post-acquisition processing and analysis algorithms make the introduction of digital detectors for breast imaging an additional benefit. By getting two views of each breast - the cranio-caudal (CC) and the medio-lateral oblique (MLO) viewsduring screening mammography, the problem of tissue superposition and performance loss in dense breasts is lessened. The interpreting radiologist compares these two views in an effort to think critically about whether a candidate lesion seen in one view is present in the other or can be discounted as random tissue superposition. They also hope that a different breast compression direction will cause an otherwise occult lesion to be visible in at least one of the views8.
Film-screen mammograms - Black and white images are produced by mammography on film. The film is used by doctors to examine the findings and determine whether there are any problems. This is a slower procedure that used to happen more frequently a few years ago. By using this tumor that are not measurable can be found using x-ray scans and useful to find out minute problems9.
Analog mammography - In analogue mammography, breast tissue changes are identified using low radiation doses that produce X-rays. Film cassettes use the radiation from an X-ray as a source to create a film that shows the breast from several perspectives. The film can be examined by the doctor or translated using computed radiography into a digital image10.
Mammography screening effectiveness
Mammography screening of women between the ages of 50 and 74 can lower the risk of breast cancer death by 20–25%. Because mammography screening schemes had not been in existence for long enough at the time, there was a lack of information allowing an evaluation of the effectiveness; therefore, the Handbook's conclusions were primarily based on the findings of breast-screening trials [11].
Detection of cancer by screening mammography
Breast cancers that are detected in women who participate in screening comprise asymptomatic malignancies discovered during screening and interval cancers. Asymptomatic ductal carcinoma in situ (DCIS) frequently has calcium deposits, which can be easily detected with x-ray-based approaches. The sensitivity of mammography is significant [12].
Are Mammograms safe?
Breasts undergo minimal radiation exposure during mammograms. However, the advantages of mammography outweigh any possible radiation exposure risks. Breast x-rays taken with modern equipment have an excellent image quality despite using modest radiation doses. For a conventional mammography with two views of each breast, the overall dose is typically around 0.4 millisieverts (mSv represents a unit of radiation exposure). The radiation exposure from 3D mammograms can be marginally lower or marginally higher than that from traditional 2D mammography. In the US, people are typically exposed to around 3 mSv of radiation annually merely from their surroundings, which helps put these amounts into context. Background radiation is the term for this. A screening mammography for both breasts uses around the same amount of radiation that a woman would naturally absorb over the course of seven weeks. Inform the x-ray technician and your healthcare practitioner if there's even a remote possibility that you might be pregnant. Mammograms are not regularly performed in pregnant women who are not at greater risk for breast cancer, despite the fact that the danger to the fetus is very low and that they are widely regarded as safe during pregnancy. The advantages of mammography are, at 11 years of follow-up, data from mammography screening programmes point to a 20% reduction in breast cancer mortality, as with other screening tests, mammography screening might produce erroneous positive results; according to estimates, this represents about 20%. Over diagnosis is a risk associated with mammography screening. The quantitative estimates of overdiagnosis in the various age groups are currently characterized by a high degree of uncertainty [13].
Types of mammograms
Screening mammograms: Women who have no symptoms or issues with their breasts get a screening mammography to look for indicators of breast cancer. Each breast is imaged using an X-ray machine from two distinct angles, generally.
Diagnostic mammograms: Mammograms are used to examine a woman's breast when she exhibits breast symptoms or when an atypical finding is made during a screening mammography. They are known as diagnostic mammograms when utilized in this fashion. They could contain extra breast views (images) that aren't included in screening mammography. Women who have already undergone treatment for breast cancer may occasionally be screened using diagnostic mammography [14].
Working of mammogram
The patient's breast is placed on a flat support plate and squeezed with a parallel plate called a paddle during a mammogram. “A brief burst of x-rays is produced by an x-ray machine and passes through the breast to a detector on the opposite side. A photographic film plate, which captures the x-ray image on film, or a solid-state detector, which transmits electronic signals to a computer to generate a digital image, can be used as the detector. Mammograms are the images that are created Low-density tissues, such as fat, look translucent on a film mammography (i.e., darker shades of grey approaching the black background), whereas dense tissues, such as connective and glandular tissue or tumors, appear whiter on a grey backdrop.” A normal mammogram includes a top and side view of each breast, with additional views performed if the physician is worried about a suspicious area of the breast. The working of the Mammography Detection is given in the Figure 4 [15].
Figure 4: Mammography Detection
Need of compression on the breast
Compression maintains the breast in position to reduce patient movement-related x-ray image blurring. Additionally, compression evens up the breast's contour so that the x-rays have a less way to take in order to reach the detector. This lessens the emission exposure and enhances the image of the x-ray. At the end, compression makes it possible to see all the tissues in one plane, which reduces the likelihood that tiny anomalies may be covered up by breast tissue [16]. Women of age of 40’s advised to go for screening mammogram for every one to two years. Mammograms for screening should be performed on women in their 50s every year. Two breast images are routinely taken during screening mammography from the above (cranial-caudal view, CC) and from an oblique (mediolateral-oblique, MLO). A diagnostic mammogram may be done to investigate an anomaly found during a physical examination or screening mammogram. Taking additional views that are customized to the particular issue during diagnostic mammography may be necessary i.e., each side which includes latero medial, and mediolateral view, cranial-caudial and other views (spot compression, magnification views). If an anomaly is found during mammography diagnostic, further breast imaging, such as ultrasound or biopsy to be used as a kind of follow-up.
Mediolateral oblique view (MLO)
A viewpoint that is angled or oblique is used to capture the mediolateral oblique view (MLO). “The MLO view is preferred during routine screening mammography over a lateral 90-degree projection because more breast tissue may be visible in the upper outer quadrant of the breast and the axilla (armpit). Before capturing an MLO view in step 1, the mammography technologist will set the angle for the appropriate projection (30 degrees to 60 degrees) [17]. An object table is the pedestal that supports the breast and contains the film cassette or digital detector. The top edge of the object table should be parallel to the pectoral (chest) muscles and level with the axillary (armpit) fold. In step 2, patient should remain still and maintain a 45-degree angle with the mammography stand during an MLO view. The technician will urge the patient to elevate her elbow while keeping a firm grip on the machine's handle. The technician will pull the medial (middle) portion of the breast forward while the patient leans slightly forward and the technician will hold the elevated arm and breast from below. The technician will hold the patient's collarbone (clavicle) such that the compression plate just clears the bone once compression has been applied. The technician will check to make sure nothing is obstructing the desired image's field of view after the compression is adequate”. In step 3, technologist will ask the patient to stand very still after positioning her before departing to make the exposure [18]. The images of MLO given in Figure 5.
Figure 5: a) MLO view b) During MLO View Figure process c) Final position
Mammography analysis techniques
It demonstrates the many methods of mammography analysis that try to find anomalies as well as the numerous tools created for that purpose. The stages for mammogram analysis are given in Figure 6.
Figure 6: Steps in mammograms analysis
There are four crucial and complimentary approaches that can be used to summarize these processes [19].
Abnormalities shown in the mammograms
Frequently, unusual breast tissue can be seen on mammograms. They can aid medical professionals in determining whether additional testing (such a breast biopsy) is necessary, but they cannot definitively determine whether an atypical spot is cancer. Using a mammography, the following primary breast alterations can be identified: Calcifications, Masses and Distortions [20].
Types of results getting from a screening mammogram
The Breast Imaging Reporting and Data approach (BI-RADS), a standard approach for medical reporting, is used by radiologists and other healthcare professionals to explain screening and diagnostic mammography findings. The outcomes are categorized by this system into groups with numbers 0 through 6. The categories of BI-RADS is given in the Table 121.
| BI-RADS Category | Definition | Explanation |
| 0 | Incomplete. | The radiologist should compare your most recent mammogram with older ones to see if there have been changes in the area over time. |
| 1 | Negative. | No abnormal areas or findings. |
| 2 | Benign (noncancerous) finding. | Found a benign (noncancerous) structure in your breast, such as benign calcifications, lymph nodes, cysts |
| 3 | Probably benign finding. | The findings in this category have a greater than 98% chance of being benign (noncancerous). But since it’s not proven to be benign. |
| 4 | Suspicious abnormality. | This result means the finding(s) could be cancer but are not guaranteed to be cancer. The radiologist recommends a breast biopsy to get more information. |
| 5 | Highly suggestive of malignancy. | This result means the findings look like cancer and have at least a 95% chance of being cancer. |
| 6 | Known biopsy-proven malignancy. | Radiologists only use this result for findings on a mammogram that have previously been diagnosed to be cancer by a biopsy. |
Table 1: Categories of BI-RADS
Basic tests to improve the quality in mammography as a tool. The performance and quality of mammography instrument are tested by various quality tests. The test and instruments used to assess the quality are listed in Table 2.
| S. No | Test name | Equipment used | Type of measurement |
| 1. | Process development |
| The optical density was measured |
| 2. | AEC System |
|
Solidity exposure |
| 3. | Compression force | Three mammographic scales | Measure the force of compression |
| 4. | Analysis results of rejected films |
- |
5980 mammogram films |
Table 2: Test and equipment used to measure the quality
The following tools were used: a viewing box, a pair of magnifying glasses, a densitometer, a sensitometer, electronic and mammographic scales, PMMA plates, a Europhantom, a screen film contact phantom, and thermometer. To check the mammography unit's quality control, four tests were conducted [22].
Emerged companies in the mammography industry
Canon Medical Systems - Canon Medical, which was established in 1930, provides a broad selection of diagnostic medical imaging solutions, including CT, MR, X-Ray, Ultrasound, and Healthcare Informatics, to clients all over the world. In Tochigi, Japan, the headquarters are located.
Siemens Healthineers - Through its subsidiaries, Siemens Healthineers AG creates, produces, and distributes a variety of diagnostic and therapeutic goods and services to healthcare providers all over the world. Germany's Erlangen serves as the organization's headquarters.
Planmed Oy - The business sells mammography and orthopedic imaging products that are renowned for their imaging quality, usability, and superior ergonomics. The corporate headquarters of the corporation are in Helsinki, Finland.
Konica Minolta Inc - Konica Minolta, Inc. operates in the fields of industrial, healthcare, professional print, and digital workplace. The headquarters of Konica Minolta, Inc. are in Tokyo, Japan, where it was established in 1873.
MetaltronicaSpA - Metaltronica, a diagnostic imaging industry leader with a substantial market share in both domestic and foreign markets, was founded in 1977. The corporate offices of the corporation are in Pomezia, Italy.
Global mammography market
The size of the worldwide mammography market was estimated at USD 1.95 billion in 2021, and it is projected to increase at a CAGR of 10.26% from 2022 to 2030. “One of the main reasons projected to fuel demand for breast cancer diagnostic equipment throughout the forecast period is the rising prevalence of breast cancer and the rising demand among patients for early-stage diagnosis.” The U.S mammographymarket size by product graph below as Figure 7.
Figure 7: Expected U.S mammography market size
Globally, there was a considerable decline in cancer screening, cancer management visits, and cancer operations as a result of the COVID-19 pandemic. In some locations of the United States, mammograms decreased by up to 92% at the pandemic's height in 2020, according to a report published in the Journal of the American College of Radiology. The FDA reports that 38.8 million women were screened for breast cancer in 2021, which suggests that hundreds of thousands of women in the United States may have postponed or missed their exams as a result of the pandemic.
Regional insights:
With a revenue share of over 36.4% in 2021, North America led the world market and is predicted to rise at a significant rate throughout the forecast period. “One of the main variables influencing the local market is the increasing prevalence of breast cancer. The American Cancer Society estimates that in 2020, there will be around 276,480 new cases of invasive breast cancer in women. In addition, it has been determined that 48,530 women have in situ breast cancer, and it is anticipated that this figure will increase in the upcoming years.” The American organization that provides free mammograms and breast cancer education to needy women in the National Breast Cancer Foundation (NBCF). It is projected that the presence of developing nations like China, Japan, and India will accelerate the region's growth. The regional growth of mammography is given the below. The main leaders of U.S Mammography are “Fujifilm Holdings Corporation, GE Health care, Hologic Inc, Koninklijke Philips NV and Siemens A”.
Indian Mammography market
At a CAGR of 10.53% over the forecast period (2023-2028), the India Mammography Market is anticipated to increase from USD 60.93 million in 2023 to USD 100.52 million by 2028.The Aster RV Breast Clinic, which uses 2Dadvanced, mixed with mammograms 3D, breast ultrasounds, biopsies, and breast MRI to accurately detect and treat all breast-related disorders, opened in India in November 2020. This will probably accelerate the growth of the market. In the long run, this can increase the demand from these facilities for mammography equipment. The mark share of the Indian mammography is given in the Figure 8.
Figure 8: Expected market share of the Indian mammography
The main mammography leaders of Indian market are “Siemens AG, Planmed OY, Hologic Inc, Fujifilm Holdings Corporation and GE Health care”.
Mammography Quality Standards Act (MQSA)
The Mammography Quality Standards Act, which was passed by Congress in 1992 and went into force in 1994, is known by the acronym MQSA. With the help of this law, mammography facilities and doctors who perform mammograms on patients will be held to a set of quality standards. Due to the MQSA, all mammography facilities in the US were compelled to follow a set of minimal standards in order to maintain their MQSA certification and their rights to go on offering mammography services. It consists of approval must be done by the FDA For accreditation organization, should meet the FDA or State Approval standards, mandatory to qualify the annual MQSA inspection, the MQSA certificates approval should be displayed prominently, it should conduct an annual Medical Physicist survey on all mammography equipment and it must maintain ACR accreditation by an FDA approved accrediting body
MQSA requirements for mammography
To perform a mammography on a patient, one needs extensive training. It requires more now than it did in the 1990s, at least. At this time, Congress started to pay attention to the caliber and expertise of mammography. Before the passage of this landmark legislation, many facilities in the US
produced and interpreted subpar images using out-of-date technology and untrained radiologists and technologists with inadequate training. This meant that the photos that were taken weren't as useful as they may have been in identifying breast cancer. There were also issues with how patients were informed of their results. There were also few programmes in place that gave patients the chance to voice their objections. But with the passage of the Mammography Quality Standards Act in 1992, everything changed. Since then, significant improvements have been made to the entire set of MQSA criteria [23].
Mammography screening guidelines recommended by the six us medical organizations
On June 22, 2017, the American Congress of Obstetricians and Gynecologists (ACOG) published updated breast cancer screening recommendations for women with an average risk of developing the disease. The new regulations were given by the ACOG. The new guidelines recommend women for the screening mammography over the age of 40 every one to two years, with the first screening mammogram occurring no later than age 50. The decision to continue screening mammography in women over the age of 75 should be made by each woman in consultation with her healthcare provider and should take into account the woman's health status and expected lifespan. There are little changes from the numerous medical organizations regarding the mammography screening guidelines [24]. The recommendations of six US medical organizations are summarized in Table 325.
| Organization | Starting age (years) | Stopping age | Mammography interval |
| AAFP | 50 recommended, individual decision from 40-49 | 74 years | Every 2 years |
| ACR/SBI | 40 | No specified age, tailored to health status of patient | Annually |
| ACS | 45 recommended; option to start at 40 | Continue to life expectancy <10> | Annually between 45-54; every 1 or 2 years at 55+ |
| ACOG | Offer at 40, not later than 50 | Age 75, then shared decision making | Every 1 or 2 years |
| NCCN | 40 | Upper age limit for screening, not established, consider severe comorbidities limiting life expectancy | Annually |
| USPSTF | 50 | 74 years | Every 2 years |
Regulations of Mammography Quality Standards Act (MQSA)
The quality standards of the Mammography Quality Standards Act’s, which were designed, go into force as of the following act i.e., 21CFR900- Mammography standards act [26]. This act having number of subparts, part-A deals with accreditation process, subpart B deals with quality standards and certification and Subpart C deals with states as certifiers. The Mammography Quality Standards Act (MQSA), codified at 42 U.S.C. 263b, is carried out via the rules outlined in this part. The processes for applying to become approved accreditation organization, which certifies the provisions as being qualified to provide screening or diagnostic mammography services, are outlined in Subpart A of this part. The procedures and standards for accreditation organizations are further established in Subpart A to guarantee that all mammography provisions subject to US jurisdiction are suitably assessed for compliance with quality standards. To promote safe, dependable, and accurate mammography, this part's subpart B defines minimum national quality requirements for mammography facilities. Facilities owned or operated by the Department of Veterans Affairs are exempt from the restrictions in this chapter [27]. “In Subpart C of this part, the procedures for applying to a State to become a certification agency designated by the FDA to certify businesses within the State to offer mammography services are laid forth. Subpart C of this part further establishes requirements and standards for State certification agencies to ensure that all mammography facilities under their jurisdiction are properly and consistently evaluated for compliance with quality standards at least as stringent as the national quality standards established by FDA”.
The MQSA program's most frequently requested national statistics are provided in this area of MQSA Insights. Every month on the first, these stats are updated. Table 4 provided national statistics relating to the MQSA programme. The number represents the average of all yearly procedures that facilities reported to their accrediting bodies at the time of their re-accreditation, which takes place every three years. Only information supplied by non-veterans’ hospital administration hospitals that were MQSA-certified was pooled. The sum could not possibly reflect the volume of procedures now performed at these institutions. It contains computed radiography and full field digital mammography units. It also facilities with FFDM also have DBT; hence the number of DBT facilities is included in the total number of digital facilities.
| Certified facilities, as of October 1,2022 | 8,790 |
Certification statistics, as of May 1, 2023 Total certified facilities/Total accredited units Certified facilities with 2D digital units / Accredited 2D digital units Certified facilities with DBT digital units / Accredited DBT digital units | 8,829/24,904 8,825/ 13,370 7,628/11,531 |
Percent of inspection where the highest noncompliance was a: Level 1 violation Level 2 violation Percent of inspections with no violation |
1% 10.9% 88.1% |
| Total annual mammography procedure reported, as of May 1, 2023 | 39,732,862 |
Table 4: National statistics regarding the MQSA program
Case study on mammography
Mammography Problems at Capitol Radiology, Laurel, Maryland: FDA Safety Communication issued on June 30, 2022. Concerns about the caliber of mammograms conducted at Capitol Radiology, LLC were brought to the FDA's attention [28].A Full Field Digital Mammography (FFDM) unit was not accredited by the provisions accrediting organization, the American College of Radiology, the provision dialed too conduct quality control test of an imaging unit for 12 .Due to the provision’s failure to operate in accordance with the MQSA, the FDA advised the provision that it needed to conduct an Additional Mammography Review (AMR) to check whether the general caliber of mammography performed at the facility had been harmed and whether it was necessary to notify patients who might have been affected [29].
Warning letter
The warning letter was issued for the company East Jefferson General hospital in 13/11/19.This letter is on behalf of FDA; they have inspected your facility and your facility did not meet the conditions of Mammography Quality Standard Act to practicing mammography and conditions present in the section 263b of Tittle 42 of USC. The issues involved are, the x-ray unit 98, 12 room of mammography 3 is not accredited as per 21 CFR Part 900.4(a), (b) &(c) (4).
Mammography is a valuable and crucial diagnostic tool used in the detection of breast cancer by two types of views i.e., cranial - caudal view and mediolateral-oblique view. Screening of breast cancer allows identifying the abnormalities such as tumor or calcifications that may indicate the presence of cancer. Advancement technologies present in the mammography such as 3D mammography (tomosynthesis), digital mammography etc. This article also provides the analysis steps for the mammography detection. There are certain quality tests for the improvement of the mammogram quality. Based on the existing research evidence mammography has been shown to reduce the breast cancer mortality rates by detecting tumors at the early stage. The growth of the mammography market in the U.S and India has been increasing vastly. Some of the U.S organizations recommended mammography screening guidelines for breast cancer detection. According to FDA, Mammography quality standards act regulations are mentioned in the CFR TITLE [21] PART 900. According to this CFR, the mammography facilities should be accredited and provide high quality of mammography services to the patients.
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Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
