Anxiety and Breast Imaging-Can Community Education by a Breast Radiologist Decrease Anxiety and Improve Knowledge?

Abstract Objective To define and illustrate three new descriptors for microcalcification morphology on mammography, and provide a preliminary assessment of their potential clinical value. Methods The institutional review board approved this retrospective study and waived the requirement for informed consent. One thousand consecutive biopsy-proven cases of microcalcifications were retrospectively reviewed by the index study observer, a fellowship-trained breast radiologist blinded to histologic outcome. Each case was evaluated for traditional Breast Imaging Reporting and Data System (BI-RADS) morphology descriptors, as well as for the presence of one of three proposed new calcification morphology descriptors: (1) square, (2) sandwich, and (3) teardrop, pill & capsule. Positive predictive value (PPV) for each proposed shape was calculated. Interobserver variability was calculated on a subset of 200 cases, which were evaluated by two additional breast radiologists blinded to the interpretation of the index observer. Results Of 1000 cases, 702 (70.2%) were benign, and 298 (29.8%) were malignant. There were 51 (5.1%) square and 60 (6.0%) sandwich calcification cases, which were all benign at biopsy (PPV, 0%). Of the 106 (10.6%) cases that included teardrop, pill & capsule calcifications, 90 were malignant (PPV, 84.9%). Interobserver variability for the traditional BI-RADS morphology descriptors (κ = 0.40) was comparable to observer variability of the proposed new morphologies: square (κ = 0.39), sandwich (κ = 0.47), and teardrop, pill & capsule (κ = 0.49). Conclusion The proposed calcification descriptors square and sandwich-shaped had a PPV of 0%, and they may represent new typically benign morphologies. In contrast, teardrop, pill & capsule–shaped calcifications indicate a higher likelihood of malignancy than that of previously established descriptors.

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One-minute Preceptors in Action: Breast Radiologists and the Medical Student General Radiology Elective

Journal of Breast Imaging ◽

10.1093/jbi/wbaa058 ◽

2020 ◽

Author(s):

Sheila S Lee ◽

Gary L Beck Dallaghan ◽

Jorge D Oldan ◽

Sheryl G Jordan

Keyword(s):

Medical Student ◽

Medical Students ◽

Learning Styles ◽

Breast Imaging ◽

Positive Impact ◽

Teaching Strategy ◽

Learning Experiences ◽

High Yield ◽

Yield Learning ◽

Breast Radiologist

Abstract Breast imaging, with its unique patient-facing, multimodality, and multidisciplinary workflow, offers opportunities to engage medical students enrolled in a general radiology rotation and to highlight the role of the radiologist in patient care. At a time when breast radiologists face unprecedented challenges in delivering safe and efficient imaging services, however, accommodating larger numbers of medical students can overwhelm reading rooms, dilute meaningful learning experiences for the student, and place further demands on faculty. In order to meet the students’ and clinician educators’ needs, Neher’s one-minute preceptor teaching strategy is used to create a high-yield learning environment in a short amount of time. In this model, the breast radiologist weaves together multiple impactful and varied learning experiences in only 8 to 12 total hours of structured student exposure during the 160-hour general radiology course. We describe our adaptation of this technique and the positive impact that a short breast imaging component had on our general radiology medical student rotation. This standardized curriculum is easily adapatable to a variety of learning styles. It contributes to medical students’ understanding of the various facets of radiology through direct participation and exceeds education goals set forth by the Alliance of Medical Student Educators in Radiology. Students’ evaluations of the general radiology rotation demonstrated a sharp uptick in the year following the adoption of the technique, and students’ rotation final examination mean scores on the breast questions were higher for students who participated at least eight hours on service in the breast radiology clinic.

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Emergency Breast Imaging, What Radiologists Need To Know

American Journal of Sonography ◽

10.25259/ajs_3_2021 ◽

2021 ◽

Vol 4 ◽

pp. 4

Author(s):

Abdelmohsen Radwan Hussien ◽

Monaliza El-Quadi ◽

Rola Shaheen ◽

Mohamed Elfar ◽

Avice O’Connell

Keyword(s):

Breast Imaging ◽

Severe Infection ◽

The Past ◽

General Radiologist ◽

Breast Radiologist

Awareness by the general radiologist of the various emergent conditions of the breast would enable a better management and appropriate referral, rather than postponing management till a breast radiologist is available for consultation. Early referrals are essential to prevent deterioration of complications including severe infection and even sepsis. There has been a lack of consensus in the past regarding appropriate management and delays in treatment have resulted in worse outcomes which could have been avoided.

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Adding Triage Ultrasound to a Breast-Cancer Detection Model in Peru

Journal of Global Oncology ◽

10.1200/jgo.18.36300 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 41s-41s

Author(s):

C. Bain ◽

J. Scheel ◽

V. Castillo ◽

V. Tsu

Keyword(s):

Breast Cancer ◽

Early Detection ◽

Breast Imaging ◽

Community Education ◽

Needle Aspiration ◽

Northern Region ◽

Local Hospital ◽

Expert Radiologist ◽

General Physicians ◽

Triage Algorithm

Background: The rising breast-cancer burden in middle-income countries is straining the capacity of health systems to provide early detection and diagnostic services. To bring these services to women in a northern region of Peru, community education and clinical breast exam (CBE) by midwives was introduced as a method for screening asymptomatic women and evaluating women with symptoms; if positive, women were evaluated further by fine needle aspiration (FNA) by a trained physician at a local hospital. Aim: During the pilot phase, this early detection program resulted in increased demand for cytopathology services, invasive procedures for patients, delays in results, and high rates of benign findings. We added basic triage ultrasound (US), performed and interpreted by general physicians at a local hospital, to further evaluate women with a positive CBE and reduce the number of unnecessary FNAs. We aim to evaluate the changes in the FNA rate. Methods: PATH worked with an expert radiologist to develop a breast-US training program that included: teaching physicians to perform and interpret breast US using a triage algorithm based on the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) and a standardized checklist to document clinical and US findings. The triage algorithm was reviewed and validated by oncologists at Peru's national cancer institute, and later introduced in ten networks in northern Peru. Results: After adding triage ultrasound in 2015, a total of 133 CBE+ women received US at the local hospital; 73 women had a finding on US indicating a need for FNA biopsy, and all received it. Eleven of these women were subsequently diagnosed with breast cancer. Without triage US, all 133 CBE+ women would have received FNA. This represents a 55% decrease (60/133) in FNA biopsies. Conclusion: Triage ultrasound, as part of a resource-adapted model of breast screening, combined with FNA sampling increases the ability of general physicians to manage CBE+ women locally, thereby reducing health system burdens and assuring that patients at highest risk receive timely referrals to a specialized hospital. Triage ultrasound reduces the biopsy rate following a positive CBE. As ultrasound technology becomes more accessible and less expensive, we anticipate there will be an even more significant role for it in early detection models.

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Comparison of breast density assessments according to BI-RADS 4th and 5th editions and experience level

Acta Radiologica Open ◽

10.1177/2058460120937381 ◽

2020 ◽

Vol 9 (7) ◽

pp. 205846012093738 ◽

Cited By ~ 1

Author(s):

Aysegul Akdogan Gemici ◽

Ersoy Bayram ◽

Elif Hocaoglu ◽

Ercan Inci

Keyword(s):

Breast Density ◽

Breast Imaging ◽

Important Variable ◽

Experience Levels ◽

Significant Difference ◽

Breast Radiologist ◽

The Difference ◽

Level Of Experience ◽

Different Levels ◽

Reporting Data

Background Breast density is an important variable that can change the sensitivity of mammography. It can be analyzed with using the 4th and 5th editions of the Breast Imaging and Reporting Data System (BI-RADS) recommendations from the American College of Radiology (ACR). Purpose To define the intra- and inter-reader agreement levels of breast density assignments performed by readers with different experience levels using two versions of BI-RADS. Material and Methods The breast density assessments of 330 women were conducted by two readers with different levels of experience (one breast radiologist and one resident). Each reader independently defined the breast density four times—twice using the 4th edition and twice using the 5th edition. Assessments were analyzed on four- and two-category scales. Results The intra-reader agreement of the breast radiologist for the 4th and 5th editions of BI-RADS was almost perfect (k = 0.90 and k = 0.87, respectively.) The resident had similar results (k = 0.88 and k = 0.87, respectively). The agreement between the breast radiologist and resident for the 4th and 5th edition of BI-RADS was substantial (k = 0.70 and k = 0.63, respectively). There was a statistically significant difference with the two-category scale analysis between the dense and non-dense for both readers and versions of BI-RADS (McNemar’s test, P < 0.001). Conclusion Although there were high intra- and inter-reader agreement levels when using both versions, the percentage of women having dense breasts increased when using the 5th edition, and the difference was statistically significant. There were no differences found with regard to the readers’ level of experience in all analyses.

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Patient Diversity in Breast Imaging: Barriers and Potential Solutions

Journal of Breast Imaging ◽

10.1093/jbi/wbaa092 ◽

2020 ◽

Author(s):

Miral M Patel ◽

Jay R Parikh

Keyword(s):

Breast Imaging ◽

Provider Education ◽

Mobile Mammography ◽

Current Trends ◽

The Face ◽

Care Gaps ◽

Breast Radiologist ◽

Access And Quality ◽

Specific Barriers

Abstract Recent reports have highlighted disparities in breast cancer care related to patient diversity. Breast radiologists represent the face of breast imaging and are key players in advocating for patients to reduce these disparities. Diversity-related barriers for breast imaging patients, as they journey from screening to survivorship, include impediments to access and quality of care, gaps in communication, and lack of knowledge in both providers and patients. Potential strategies for overcoming these specific barriers include “culturally tailored” nurse navigators, mobile mammography, improved communication, patient and provider education, and breast radiologist involvement in advocacy efforts promoting diversity. As current trends in recommendations and guidelines for breast imaging include more numerous and advanced imaging modalities, it is important to acknowledge and address diversity-related disparities.

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