Journal of Breast Imaging最新文献

{"title":"Relative Costs and Outcomes of a Contrast-Enhanced Mammography-Guided Biopsy Trial.","authors":"Jameson Cumsky, Abeer Mousa, Margarita Zuley, Richard Sharpe, Laura K Harper, Molly Harrison, Victor Pizzitola, Marie A Ganott, Bronwyn Nair, Adrienne Vargo, Kimberly Harnist, Uzma Waheed, Amy E Kelly, Bhavika Patel","doi":"10.1093/jbi/wbaf019","DOIUrl":"https://doi.org/10.1093/jbi/wbaf019","url":null,"abstract":"<p><strong>Objective: </strong>To assess the performance and cost implications of contrast-enhanced mammography-guided biopsy (CEM Bx).</p><p><strong>Methods: </strong>This is a prospective study from May 5, 2021, to April 18, 2022, across 2 U.S. academic centers, evaluating technical success, patient/radiologist feedback, and operational factors of CEM Bx. Inclusion criteria included that patients be 40 years or older and recommended for biopsy with suspicious findings on contrast-enhanced mammography (CEM). Descriptive statistics are reported for clinical outcomes, length of procedure, and user and participant feedback. An estimate of cost was made by comparing general Medicare costs that are being billed for CEM Bx and post-clip mammogram ($475.48) to the Medicare costs of MRI-guided biopsy (MRI Bx) and post-clip placement mammogram ($845.94).</p><p><strong>Results: </strong>Eighty-two participants enrolled. Twenty-two were excluded at the time of CEM Bx (22/82, 27%). Sixty participants were included (mean age 57 years, range 33 to 81 years) with 63 suspicious CEM lesions. The malignancy rate was 22% (14/63). A technical success rate of 100% was achieved. Average CEM Bx time was 29% to 33% the average reported MRI-guided breast biopsy times (CEM Bx = 11 minutes; MRI Bx = 33 to 38 minutes), indicating operational efficiencies. A positive opinion of CEM Bx was reported by 78% of radiologists, 93% of technologists, and 98% of patients. The estimated cost for each CEM Bx was ~ 45% lower than MRI Bx.</p><p><strong>Conclusion: </strong>CEM Bx demonstrates high success rates and satisfaction scores. CEM Bx resulted in shorter procedure times, enhanced operational efficiency, and ~45% reduction in costs compared with MRI Bx. As advancements continue, we anticipate CEM Bx will offer a cost-efficient and timely option for breast biopsy.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Axillary Arch Variant Anatomy on Breast MRI and Impact on Axillary Lymph Node Assessment.","authors":"Anne Elizabeth Kendell, Samantha Yost, Kristie Yang, Megan Mills, Nicole Winkler","doi":"10.1093/jbi/wbaf023","DOIUrl":"https://doi.org/10.1093/jbi/wbaf023","url":null,"abstract":"<p><strong>Objective: </strong>To assess the prevalence of the axillary arch (AA) variant and its impact on the sensitivity of US vs MRI for detecting axillary nodal metastases in patients with breast cancer.</p><p><strong>Methods: </strong>The IRB waved informed consent for this retrospective study. Three hundred, eighty-two breast MRIs performed for the extent of disease of breast cancer between 2012 and 2023 were reviewed for the presence of AA. Pre-MRI axillary US was available in 322 of these cases. The presence of axillary adenopathy was documented and correlated with pathology. A paired sample comparison was used to calculate sensitivities of US and MRI for detection of the AA.</p><p><strong>Results: </strong>The AA was detected on breast MRI in 6.8% (26/382) of patients. Of these, 30.8% (8/26) were bilateral, 50% (13/26) were unilateral left, and 19.2% (5/26) were unilateral right. All had lymph nodes both superficial and deep to the AA. Of the 26 patients with AA, 19 patients underwent pre-MRI axillary US. Biopsy-proven malignant adenopathy was detected on MRI but missed on US in 10.5% (2/19) of patients with AA but only 2.5% (7/279) of patients without AA. Sensitivity for detection of lymphadenopathy on MRI and US was 69.7% (82/122)% and 67.5% (77/114) for all patients (P = .17), 72.2% (78/108) and 68.5% (74/108) for patients without AA (P = .21), and 66.2% (4/6) and 50.0% (3/6) for patients with AA. The small sample size of patients with AA precluded statistical comparison.</p><p><strong>Conclusion: </strong>The AA is a common variant detectable on breast MRI. Axillary nodal metastases may reduce US sensitivity for identifying nodal metastases. Further investigation is required to establish statistical significance.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Percutaneous Drain Placement for Postsurgical Breast Region Fluid Collections.","authors":"Sanna E Herwald, Wenhui Zhou, Debra Ikeda, Alexander Vezeridis","doi":"10.1093/jbi/wbae086","DOIUrl":"10.1093/jbi/wbae086","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to describe the safety and efficacy of percutaneous drain placement for postoperative fluid collections in the breast.</p><p><strong>Methods: </strong>A retrospective review was conducted of the patient characteristics, intervention data, and clinical outcomes of the 43 adult patients who underwent percutaneous drain placement for fluid collections at a tertiary care hospital over a 13-year period ending February 28, 2023.</p><p><strong>Results: </strong>Most fluid collections treated with percutaneous drain placement were secondary to ipsilateral breast surgery (92%, 44/48), most commonly breast reduction (23%, 10/44) and mastectomy with immediate tissue expander reconstruction (16%, 7/44). Additional patients had fluid collections without prior ipsilateral breast surgery (8%, 4/48) and were excluded from further analysis. The fluid cultures from 39% of the cultured postsurgical fluid collections were positive (16/41), and Staphylococcus aureus was the most commonly cultured organism (15%, 6/41). The only immediate complication was the rupture of a tissue expander during drain placement in 1 patient. The median duration of percutaneous drainage for postsurgical fluid collections was 12 days (range: 1 to 49 days). Percutaneous drain placement achieved clinical success without any subsequent treatments in 73% (32/44) of patients. An additional 7% (3/44) of patients required subsequent image-guided aspiration procedures and/or percutaneous drain placements but avoided surgical treatment for a persistent fluid collection.</p><p><strong>Conclusion: </strong>Postsurgical fluid collections after diverse breast surgeries represented the vast majority of the fluid collections referred to our academic practice for percutaneous drain placement. Percutaneous drain placement was a safe and effective treatment in this patient population.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"311-317"},"PeriodicalIF":2.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing Errors in Breast Imaging: Insights From Missed and Near-Missed Cases.","authors":"Xiaoqin Wang, Braxton McFarland, Emily Xiao, Ryan Anderson, Laurie Fajardo","doi":"10.1093/jbi/wbaf005","DOIUrl":"10.1093/jbi/wbaf005","url":null,"abstract":"<p><p>Errors and misdiagnosis in breast imaging are significant concerns for breast imaging radiologists due to the negative impacts on patients and the high legal risks. Using missed and nearly missed diagnoses of breast cancer cases, this article introduces radiologists to common factors contributing to errors and misdiagnosis in breast imaging, including radiologist errors, improper imaging techniques, lesion characteristics, and work environment challenges. The article also provides practical recommendations and potential strategies to reduce these errors focusing on actions applicable to individual radiologists. Understanding the common causes of diagnostic errors in breast imaging and implementing targeted mitigating strategies can help radiologists improve diagnostic precision, reduce malpractice risk, and enhance patient care.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"363-377"},"PeriodicalIF":2.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sociodemographic Factors and Ethnic Disparities in Breast Density Awareness and Anxiety Among Women With Dense Breasts.","authors":"Linda H Larsen, Katherine A Rosenberg, Taylor F Mahoney, Patrick H Walker, Mary Yamashita","doi":"10.1093/jbi/wbae090","DOIUrl":"https://doi.org/10.1093/jbi/wbae090","url":null,"abstract":"<p><strong>Objective: </strong>To determine sociodemographic and clinical factors associated with breast density awareness and anxiety in women with dense breasts.</p><p><strong>Methods: </strong>This cross-sectional retrospective study, from a breast cancer screening prospective case collection registry (NCT03257839), analyzed patient-reported awareness of their breast density and related anxiety with sociodemographic variables. Asymptomatic women aged ≥40 with heterogeneously or extremely dense breasts completed a prescreening questionnaire at 9 Mammography Quality Standards Act-certified centers spanning 8 states with and without breast density notification laws (BDNLs).</p><p><strong>Results: </strong>Among 6873 women (mean age 54.6 ± 9.3 years) with 99.4% (6833/6873) questionnaire completion, 71.7% (4930/6873) of participants were aware of their breast density. Self-reported Hispanic/Latina women comprised 15.4% (1055/6873), of whom 75.5% (796/1055) had a state BDNL. Fewer Hispanic/Latina women with a BDNL in effect were aware of density than non-Hispanic/Latina women (50.7% [403/795] vs 83.9% [2416/2880], P <.001). In multivariable analyses, the adjusted odds ratio (AOR) of breast density awareness was higher in women with some college education (AOR 2.70 [95% CI, 2.36-3.08]), BDNL in effect (AOR 2.09 [95% CI, 1.86-2.34]), self-reported ethnicity of not Hispanic or Latina (AOR 1.68 [95% CI, 1.45-1.96]), and aged 70 to 79 years (AOR 1.73 [95% CI, 1.35-2.22]), 60 to 69 years (AOR 1.45 [95% CI, 1.25-1.69]), or 50 to 59 years (AOR 1.30 [95% CI, 1.15-1.48]) when compared with 40 to 49 years. Women with awareness were more likely to be anxious (AOR 1.98 [95% CI, 1.76-2.24]).</p><p><strong>Conclusions: </strong>Despite overall density awareness in women with dense breasts and BDNL implementation, health care providers should address disparities of awareness and target discussions with women under 50, individuals with a Hispanic/Latina background, and those less educated.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":"7 3","pages":"318-330"},"PeriodicalIF":2.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a Career as a Clinician-Educator in Breast Imaging.","authors":"Alison Lynn Chetlen, Jeanine Beatty-Chadha, Angela I Choe","doi":"10.1093/jbi/wbae075","DOIUrl":"10.1093/jbi/wbae075","url":null,"abstract":"<p><p>For the breast imaging radiologist, developing a career as a clinician-educator can be accomplished in a number of ways. Whether it be a new graduate or perhaps a radiologist making a midcareer or late-career pivot to the academic world, there are several opportunities and resources that can support a faculty member at any stage in this journey. In this article, the breast imaging radiologist will learn a variety of methods to strengthen their professional identity and career path as a clinician-educator through the early-, mid-, and late-career professional journey.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"355-362"},"PeriodicalIF":2.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contrast-Enhanced Mammography Implementation: Early Struggles and Successes.","authors":"Brittany Z Dashevsky, Laura J Fish, Shelby Breit, Uzma Waheed, Kristen Coffey, Jay R Parikh, Lisa A Mullen, Beatriu Reig, Brian N Dontchos, Katerina Dodelzon, Lars J Grimm","doi":"10.1093/jbi/wbaf018","DOIUrl":"https://doi.org/10.1093/jbi/wbaf018","url":null,"abstract":"<p><p>We used focus groups of radiologists who led the implementation of contrast-enhanced mammography (CEM) in their practice to identify barriers and strategies for adoption. Members of the Society of Breast Imaging in the United States who served as lead on CEM implementation were invited to participate in 2 separate focus groups. Ten breast imaging radiologists with varied geographic and practice type (60% academic, 30% private, and 10% community practice) participated. There were 4 major themes identified: patient selection, workflow, contrast, and billing. Patient selection varied widely among practices, with some limiting CEM to patients unable to obtain MRI and others routinely using CEM for diagnostic workup. Lack of Food and Drug Administration approval limited screening applications in some practices. Workflow challenges were numerous, and site-specific solutions were developed for ordering, scheduling, staffing, and intravenous access. There were universal concerns regarding contrast, including safe administration, response to reactions, and biopsy planning for findings only visible on CEM. Contrast reaction training, including conducting mock codes at some practices, helped alleviate concerns of the radiologists and technologists. Finally, billing was an administrative hurdle that influenced patient selection. Ample preparation is needed to successfully start a CEM program with particular attention to patient selection, workflow, contrast administration/reactions, and billing.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":"7 3","pages":"345-354"},"PeriodicalIF":2.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peri-Implant Enhancement of the Breast: Imaging Features, Significance, and Management Strategies.","authors":"Santo Maimone, Shweta Srivastava, Olivia S Ho, Kristin A Robinson, Andrey P Morozov, Haley P Letter, Amie Leon, Brian D Rinker","doi":"10.1093/jbi/wbae084","DOIUrl":"10.1093/jbi/wbae084","url":null,"abstract":"<p><strong>Objective: </strong>Peri-implant enhancement can be seen on contrast-enhanced breast MRI, but its association with malignancy has not been described, leading to considerable variability in assessment and recommendations by radiologists. This study evaluated imaging features, management, and outcomes of implant-related enhancement.</p><p><strong>Methods: </strong>This multisite IRB-approved retrospective review queried all breast MRI reports for keywords describing peri-implant enhancement, fluid, and/or masses (plus synonymous descriptions) and implant-associated malignancies, with subsequent imaging and chart review. Peri-implant enhancement and implant features were characterized. Assessments and outcomes were evaluated via clinical and imaging follow-up, aspiration/biopsy, and/or capsulectomy to evaluate for association of peri-implant enhancement with implant-related malignancy.</p><p><strong>Results: </strong>A total of 100 patients had peri-implant enhancement. Uniform thin peripheral enhancement was most common (79/100, 79%). Capsulectomy was performed in 31/100 (31%), with benign capsular fibrosis/inflammation discovered in 26/31 (83.9%). Breast implant-associated anaplastic large cell lymphoma was present in 2/100 (2%), both with textured implants, while 98/100 (98%) had no implant-related malignancy. MRI recommendations varied: resume routine imaging (26/100, 26%), clinical management (18/100, 18%), follow-up MRI (17/100, 17%), MRI-directed US (17/100, 17%), aspiration/biopsy (11/100, 11%), and surgical consultation (10/100, 10%).</p><p><strong>Conclusion: </strong>Peri-implant enhancement is a nonspecific imaging finding with a low malignant association, especially when seen in isolation (no associated effusion, mass, or adenopathy). Implant surface texture should be considered in management recommendations; diagnostic capsulectomy is not recommended in patients with smooth implants. Additional studies are encouraged to validate nonoperative management recommendations.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"301-310"},"PeriodicalIF":2.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unknown Case: Sixty-Four-Year-Old with a Screening Mammogram-Detected Oval Mass.","authors":"Aurela Clark, Sara Bachert","doi":"10.1093/jbi/wbae015","DOIUrl":"10.1093/jbi/wbae015","url":null,"abstract":"","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"378-380"},"PeriodicalIF":2.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Screening Outcomes: A Guide for Breast Imaging Practices.","authors":"Sora C Yoon, Jay A Baker, Lars J Grimm","doi":"10.1093/jbi/wbae093","DOIUrl":"10.1093/jbi/wbae093","url":null,"abstract":"<p><p>Radiologists face a range of challenges to maximize the life-saving benefits of screening mammography, including pressure to maintain accuracy, manage heavy workloads, and minimize the risk of fatigue and burnout. This review provides targeted strategies to address these challenges and, ultimately, to improve interpretive performance of screening mammography. Workflow optimizations, including offline vs online and batched vs nonbatched interpretation, interrupted vs uninterrupted reading, and the importance of comparing current mammograms with prior examinations will be explored. Each strategy has strengths, weaknesses, and logistical challenges that must be tailored to the individual practice environment. Moreover, as breast radiologists contend with increasingly busy and hectic working conditions, practical solutions to protect reading environments and minimize distractions, such as the \"sterile cockpit\" approach, will be described. Additionally, breast radiologists are at greater risk for fatigue and burnout due to rising clinic volumes and an inadequate workforce. Optimizing the approach to reading screens is critical to helping breast imaging radiologists maintain and maximize the benefits of screening mammography, ensure the best outcomes for our patients, and maintain radiologist job satisfaction.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"259-267"},"PeriodicalIF":2.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}