Validation of a Booklet on the Use of BI-RADS® in Mammography Examination

Background: The Breast Imaging-Reporting and Data System (BI-RADS ® ) is an international classification developed to systematize breast assessment, exam interpretation, and the preparation of reports of specific breast imaging exams. Objective: The objective of this study was to validate with experts a booklet directed to medical and nursing professionals in the Family Health Strategy on the categorization of Breast Imaging Reporting and Data System in order to describe the reports of mammography. Methods: This was a technology-validation study of the methodological-development type. The evaluation was performed with 11 experts, including seven radiologists and four mastologists, four men and seven women, with a mean age of 45 years, meantime of being in the profession of 22 years, and an average 15 years of working experience of in the field. Results: The individual, mean, and global Content Validity Index (CVI) was calculated. The booklet was validated with a CVI of 0.89. The suggestions of the experts were analyzed, and some of them were implemented for the final version of the booklet. Conclusion: The booklet was validated and will contribute significantly to the daily activities of medical and nursing professionals in the Family Health Strategy in relation to the interpretation of the mammographic report and the orientation regarding the referral, agility, and qualification of the patient to the specialized service.

Contrast-Enhanced Mammography in the Diagnosis of Breast Angiosarcoma

A 60-year-old female presented for further assessment of a new right breast lump (November 2020). She had a history of a stage I (T1bN0M0) right breast invasive mammary carcinoma, grade 2 (score 7/9) with receptors ER/PR-negative, HER2/neu-positive, diagnosed four years prior to her current presentation. At that time, she was treated with a right breast lumpectomy and local radiation. Breast assessment with contrast-enhanced mammography showed new skin thickening with associated enhancement within the palpable region. Histology of subsequent ultrasound-guided biopsy found radiation-induced breast angiosarcoma. Breast angiosarcoma is a rare entity that represents less than 1% of all breast cancers. To our knowledge, this is the first case describing the imaging findings of breast angiosarcoma on contrast-enhanced mammography.

Breast lesion detection through MammoWave device: Empirical detection capability assessment of microwave images’ parameters

MammoWave is a microwave imaging device for breast lesions detection, which operates using two (azimuthally rotating) antennas without any matching liquid. Images, subsequently obtained by resorting to Huygens Principle, are intensity maps, representing the homogeneity of tissues’ dielectric properties. In this paper, we propose to generate, for each breast, a set of conductivity weighted microwave images by using different values of conductivity in the Huygens Principle imaging algorithm. Next, microwave images’ parameters, i.e. features, are introduced to quantify the non-homogenous behaviour of the image. We empirically verify on 103 breasts that a selection of these features may allow distinction between breasts with no radiological finding (NF) and breasts with radiological findings (WF), i.e. with lesions which may be benign or malignant. Statistical significance was set at p<0.05. We obtained single features Area Under the receiver operating characteristic Curves (AUCs) spanning from 0.65 to 0.69. In addition, an empirical rule-of-thumb allowing breast assessment is introduced using a binary score S operating on an appropriate combination of features. Performances of such rule-of-thumb are evaluated empirically, obtaining a sensitivity of 74%, which increases to 82% when considering dense breasts only.

Comunicação e amamentação: simulação clínica para educação em enfermagem

O estudo objetivou desenvolver e validar cenário para simulação clínica sobre a comunicação e amamentação na Atenção Primária a Saúde. Pesquisa metodológica, com oito professores e nove pós-graduandos, em duas etapas. Os dados foram coletados no segundo semestre de 2018. Na etapa 1 realizou-se validação semântica do cenário escrito com cinco professores que preencheram instrumento. Na etapa 2 validou-se o cenário em atividade laboratorial simulada, com os demais participantes, que preencheram checklist durante o processo de simulação. Em ambas as etapas, a validação foi considerada quando se atingiu Índice de Validade de Conteúdo (IVC) superior a 0,8 para cada item dos instrumentos. Na etapa 1 todos os itens atingiram IVC de 1,0. Na validação do cenário, todos os itens atingiram IVC superior a 0,8, excetuando-se “avaliação das mamas”. Conclui-se que o cenário validado cientificamente pode ser aplicado na educação em enfermagem, bem como ser aliado na educação permanente em saúde.Descritores: Treinamento por Simulação, Aleitamento Materno, Comunicação em Saúde. Communication and breastfeeding: clinical simulation for nursing educationAbstract: The study aimed to develop and validate a scenario for clinical simulation on communication and breastfeeding in primary health care. Methodological research, with eight professors and nine graduate students, in two stages. Data were collected in the second half of 2018. In step 1, semantic validation of the written scenario was carried out with five teachers who filled out the instrument. In step 2, the scenario in simulated laboratory activity was validated, with the other participants, who completed the checklist during the simulation process. In both stages, validation was considered when the Content Validity Index (CVI) was greater than 0.8 for each item of the instruments. In step 1, all items reached a CVI of 1.0. In the scenario validation, all items reached CVI higher than 0.8, except for “breast assessment”. It is concluded that the scientifically validated scenario can be applied in nursing education, as well as being an ally in permanent health education.Descriptors: Simulation Training, Breastfeeding, Health Communication. Comunicación y lactancia materna: simulación clínica para la educación en enfermeríaResumen: El estudio tuvo como objetivo desarrollar y validar un escenario para la simulación clínica sobre comunicación y lactancia materna en la atención primaria de salud. Investigación metodológica, con ocho profesores y nueve estudiantes de posgrado, en dos etapas. Los datos se recopilaron en la segunda mitad de 2018. En el paso 1, la validación semántica del escenario escrito se llevó a cabo con cinco maestros que completaron el instrumento. En el paso 2, se validó el escenario en la actividad de laboratorio simulada, con los otros participantes, que completaron la lista de verificación durante el proceso de simulación. En ambas etapas, se consideró la validación cuando el Índice de Validez del Contenido (CVI) fue mayor a 0.8 para cada ítem de los instrumentos. En el paso 1, todos los elementos alcanzaron CVI de 1.0. En la validación del escenario, todos los ítems alcanzaron un IVC superior a 0,8, excepto la "evaluación de los senos". Se concluye que el escenario científicamente validado puede aplicarse en la educación de enfermería, además de ser un aliado en la educación permanente en salud.Descriptores: Entrenamiento Simulado, Lactancia Materna, Comunicación en Salud.

Communicating biopsy results from breast screening assessment: current practice in English breast screening centres and staff perspectives of telephoning results

ObjectiveTo record how breast screening centres in England deliver all biopsy results (cancer/non-cancer) from the breast assessment visit.DesignOnline survey of 63 of 79 breast screening centres in England from all regions (East Midlands, East of England, London, North East Yorkshire & Humber, North West, South East, South West, West Midlands). The survey contained quantitative measures of frequency for telephoning biopsy results (routinely, occasionally or never) and optional qualitative free-text responses. Surveys were completed by a staff member from each centre.ResultsThere were no regional trends in the use of telephone results services, (X² (14, n=63)=11.55, p=0.64), Centres who telephoned results routinely did not deliver results sooner than centres who deliver results in-person (X² (16, n=63)=12.76, p=0.69).When delivering cancer results, 76.2% of centres never telephone results and 23.8% of centres occasionally telephone results. No centres reported delivering cancer results routinely by telephone. Qualitative content analysis suggests that cancer results are only telephoned at the patient request and under exceptional circumstances.When delivering non-cancer results, 12.7% of centres never telephoned results, 38.1% occasionally telephoned results and 49.2% routinely telephoned results. Qualitative content analysis revealed different processes for delivering telephone results, including patient choice and scheduling an in-person results appointment for all women attending breast assessment, then ringing non-cancer results unexpectedly ahead of this prebooked appointment.ConclusionsIn the National Health Service Breast Screening Programme, breast assessment results that are cancer are routinely delivered in-person. However, non-cancer breast assessment results are often routinely delivered by telephone, despite breast screening policy recommendations. More research is needed to understand the impact of telephoning results on women attending breast assessment, particularly women who receive a non-cancer result. Future research should also consider how women themselves might prefer to receive their results.