Nidhi Sharma, Tejas S Mehta, Rifat A Wahab, Miral M Patel
{"title":"Facilitating Culturally Competent Breast Imaging Care in South Asian Patients.","authors":"Nidhi Sharma, Tejas S Mehta, Rifat A Wahab, Miral M Patel","doi":"10.1093/jbi/wbae026","DOIUrl":"10.1093/jbi/wbae026","url":null,"abstract":"<p><p>South Asians are a rapidly growing subset of the Asian population in the United States. They comprise people from multiple countries with diverse beliefs, languages, and cultural identities and values. The incidence of breast cancer is rising in South Asian women in the United States, with earlier onset and predilection for HER2-enriched tumors. Despite the rising incidence of breast cancer, participation in screening remains lower than other populations. Health care inequities in South Asian women are multifactorial and may be due to traditional health beliefs and practices, language barriers, cultural differences, and lack of overall awareness. Developing a culturally sensitive environment in breast imaging clinic practice can lead to improved patient care and adherence. Given the scarcity of data specific to the South Asian population in United States, there is a need for health service researchers and practice leaders to obtain more high-quality data to understand the needs of South Asian patient populations.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"529-538"},"PeriodicalIF":2.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141088999","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":"Women in Radiology: Challenges and Opportunities.","authors":"Jean M Seely","doi":"10.1093/jbi/wbae030","DOIUrl":"10.1093/jbi/wbae030","url":null,"abstract":"<p><p>Improving the status of women in radiology is crucial to better work environments. There is strong evidence in the business world that women leaders improve the workplace by making it more financially viable and by increasing collaboration, job satisfaction, and engagement. Diverse leadership fosters innovation, and women approach problem-solving with unique insights and collaborative styles. Gender diversity in leadership correlates with improved patient outcomes because women leaders prioritize patient-centered care and communication. Women create sustainable, productive work and improve radiology. Women serve as powerful role models, inspiring the next generation of women in radiology and addressing gender disparities. Increasing women leaders in radiology is essential to increase the number of women in radiology. This article summarizes many challenges women face when taking leadership roles: organizational biases prioritizing male viewpoints and marginalizing women's voices and contributions, a lack of role models, a lack of time (\"second shift\"), a lack of confidence, a lack of interest or perceived benefit, a lack of support, burnout, and previous poor experiences. While systemic issues are difficult to overcome, this article assists in the training and development of women radiologists by offering strategies to enhance job satisfaction and bring new and valuable perspectives to leadership.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"539-546"},"PeriodicalIF":2.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471441","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}
Sophia R O'Brien, Damien Medrano, Julia Birnbaum, Elizabeth S McDonald, Emily F Conant, Susan P Weinstein, Oluwadamilola M Fayanju, Samantha P Zuckerman, Christine E Edmonds
{"title":"Feasibility and Accuracy of Ultrasound-Guided Core Needle Biopsy for Nipple Lesions: A Pilot Study.","authors":"Sophia R O'Brien, Damien Medrano, Julia Birnbaum, Elizabeth S McDonald, Emily F Conant, Susan P Weinstein, Oluwadamilola M Fayanju, Samantha P Zuckerman, Christine E Edmonds","doi":"10.1093/jbi/wbae033","DOIUrl":"10.1093/jbi/wbae033","url":null,"abstract":"<p><strong>Background: </strong>Due to the superficial location, suspicious findings of the nipple-areolar complex (NAC) are not amenable to stereotactic or MRI-guided sampling and have historically necessitated surgical biopsy or skin-punch biopsy. There are limited reports of US-guided core biopsy of the nipple (US-CBN).</p><p><strong>Objective: </strong>We report our nearly 3-year pilot experience with US-CBN at an academic breast imaging center.</p><p><strong>Methods: </strong>An institutional review board-exempt and HIPAA-compliant retrospective review was performed. We assessed patient demographics, breast imaging characteristics, procedural data, pathology, and outcomes.</p><p><strong>Results: </strong>Nine female patients aged 27 to 64 underwent US-CBN from January 2021 to October 2023. Initial imaging abnormalities included abnormal MRI enhancement, mammographic calcifications, and sonographic masses. After initial or second-look US, all imaging findings had sonographic correlates for biopsy specimens, the majority of which were sonographic masses (8/9). US-CBN was performed by 6 breast radiologists using a variety of devices. All biopsy specimen results were concordant with sonographic abnormalities, although 1 was considered discordant from the initial abnormality seen on MRI. There were no complications, and discomfort during the procedure was well-treated. Two patients (22%, 2/9) were diagnosed with malignancy.</p><p><strong>Conclusion: </strong>This pilot study demonstrated that US-CBN can be performed by a breast radiologist for definitive diagnosis of suspicious nipple abnormalities seen on breast imaging, avoiding surgery, and maintaining nipple integrity. In our population, 22% (2/9) of US-CBNs revealed malignancy.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"485-492"},"PeriodicalIF":2.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898536","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":"Posttraumatic Breast Hemorrhage With the Development of Fat Necrosis.","authors":"William Johnson, Cherie Kuzmiak","doi":"10.1093/jbi/wbad086","DOIUrl":"https://doi.org/10.1093/jbi/wbad086","url":null,"abstract":"","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":"6 5","pages":"574-576"},"PeriodicalIF":2.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477145","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}
Andrew J Winkelman, Kassandra Tulenko, Samantha H Epstein, Jonathan V Nguyen, Clay Ford, Matthew M Miller
{"title":"Breast Cancer Screening With Automated Breast US and Mammography vs Handheld US and Mammography in Women With Dense Breasts in a Real-World Clinical Setting.","authors":"Andrew J Winkelman, Kassandra Tulenko, Samantha H Epstein, Jonathan V Nguyen, Clay Ford, Matthew M Miller","doi":"10.1093/jbi/wbae039","DOIUrl":"10.1093/jbi/wbae039","url":null,"abstract":"<p><strong>Objective: </strong>We compared the performance of 2 breast cancer screening approaches, automated breast US (ABUS) with same-day mammography (ABUS/MG) and handheld US (HHUS) with same-day mammography (HHUS/MG), in women with dense breasts to better understand the relative usefulness of ABUS and HHUS in a real-world clinical setting.</p><p><strong>Methods: </strong>In this institutional review board-approved, retrospective observational study, we evaluated all ABUS/MG and HHUS/MG screening examinations performed at our institution from May 2013 to September 2021. BI-RADS categories, biopsy pathology results, and diagnostic test characteristics (eg, sensitivity, specificity) were compared between the 2 screening approaches using Fisher's exact test.</p><p><strong>Results: </strong>A total of 1120 women with dense breasts were included in this study, with 852 undergoing ABUS/MG and 268 undergoing HHUS/MG. The sensitivities of ABUS/MG and HHUS/MG were 100% (5/5) and 75.0% (3/4), respectively, which was not a statistically significant difference (P = .444). The ABUS/MG approach demonstrated a slightly higher specificity (97.4% [825/847] vs 94.3% [249/264]; P = .028), higher accuracy (97.4% [830/852] vs 94.0% [252/268]; P = .011), and lower biopsy recommendation rate (3.2% [27/852] vs 6.7% [18/268]; P = .019) than the HHUS/MG approach in our patient population.</p><p><strong>Conclusion: </strong>Our findings suggest that ABUS/MG performs comparably with HHUS/MG as a breast cancer screening approach in women with dense breasts in a real-world clinical setting, with the ABUS/MG approach demonstrating a similar sensitivity and slightly higher specificity than the HHUS/MG approach. Additional variables, such as patient experience and physician time, may help determine which imaging approach to employ in specific clinical settings.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"493-501"},"PeriodicalIF":2.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735335","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":"Dedicated Breast CT: Getting Ready for Prime Time.","authors":"Shadi Aminololama-Shakeri, John M Boone","doi":"10.1093/jbi/wbae043","DOIUrl":"10.1093/jbi/wbae043","url":null,"abstract":"<p><p>Dedicated breast CT is an imaging modality that provides true 3D imaging of the breast with many advantages over current conventional breast imaging modalities. The addition of intravascular contrast increases the sensitivity of breast CT substantially. As such, there are immediate potential applications in the clinical workflow. These include using breast CT to replace much of the traditional diagnostic workup when faced with indeterminate breast lesions. Contrast-enhanced breast CT may be appropriate as a supplemental screening tool for women at high risk of breast cancer, similar to breast MRI. In addition, emerging studies are demonstrating the utility of breast CT in neoadjuvant chemotherapy tumor response monitoring as well as planning for surgical treatment options. While short exam times and fully 3D imaging in a noncompressed position are advantages of this modality, limited coverage of chest wall/axilla due to prone positioning and use of ionizing radiation are drawbacks. To date, several studies have reported on the performance characteristics of this promising modality.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"465-475"},"PeriodicalIF":2.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113168","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}
Daniel Mannina, Ameya Kulkarni, Christian B van der Pol, Reem Al Mazroui, Peri Abdullah, Sayali Joshi, Abdullah Alabousi
{"title":"Utilization of Texture Analysis in Differentiating Benign and Malignant Breast Masses: Comparison of Grayscale Ultrasound, Shear Wave Elastography, and Radiomic Features.","authors":"Daniel Mannina, Ameya Kulkarni, Christian B van der Pol, Reem Al Mazroui, Peri Abdullah, Sayali Joshi, Abdullah Alabousi","doi":"10.1093/jbi/wbae037","DOIUrl":"10.1093/jbi/wbae037","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to determine which qualitative and quantitative US features are independently associated with malignancy, including those derived from grayscale imaging morphology, shear wave elastography (SWE), and texture analysis.</p><p><strong>Methods: </strong>This single-center retrospective study was approved by the institutional research ethics board. Consecutive breast US studies performed between January and December 2020 were included. Images were acquired using a Canon Aplio i800 US unit (Canon Medical Systems, Inc., CA) and i18LX5 wideband linear matrix transducer. Grayscale US features, SWE mean, and median elasticity were obtained. Single representative grayscale images were analyzed using dedicated software (LIFEx, version 6.30). First-order and gray-level co-occurrence matrix second-order texture features were extracted. Multivariate logistic regression was performed to assess for predictors of malignancy (STATA v16.1).</p><p><strong>Results: </strong>One hundred forty-seven cases with complete SWE data were selected for analysis (mean age 54.3, range 21-92). The following variables were found to be independently associated with malignancy: age (P <.001), family history (P = .013), irregular mass shape (P = .024), and stiffness on SWE (mean SWE ≥40 kPa; P <.001). Remaining variables (including texture features) were not found to be independently associated with malignancy (P >.05).</p><p><strong>Conclusion: </strong>US texture analysis features were not associated with malignancy independent of other qualitative and quantitative US characteristics currently utilized in clinical practice. This suggests texture analysis may not be warranted when differentiating benign and malignant breast masses on US. In contrast, irregular mass shape on grayscale imaging and increased stiffness on SWE were found to be independent predictors of malignancy.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"513-519"},"PeriodicalIF":2.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724669","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":"Imaging Features and World Health Organization Classification of Rare Breast Tumors.","authors":"Denas Andrijauskis, Liva Andrejeva-Wright","doi":"10.1093/jbi/wbae047","DOIUrl":"10.1093/jbi/wbae047","url":null,"abstract":"<p><p>Breast radiologists encounter unusual lesions, which may not be well described in the literature. Previously based on histologic and molecular classifications, the World Health Organization (WHO) classification of tumors has become increasingly multidisciplinary. Familiarity with imaging features and basic pathology of infrequent breast lesions, as well as their current classification according to the WHO, may help the radiologist evaluate biopsy results for concordance and help direct the management of uncommon breast lesions. This review article provides a case-based review of imaging features and WHO histologic classification of rare breast tumors.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"547-566"},"PeriodicalIF":2.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126895","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}
Samantha J Smith, Sally Anne Bradley, Katie Walker-Stabeler, Michael Siafakas
{"title":"A Prospective Analysis of Screen-Detected Cancers Recalled and Not Recalled by Artificial Intelligence.","authors":"Samantha J Smith, Sally Anne Bradley, Katie Walker-Stabeler, Michael Siafakas","doi":"10.1093/jbi/wbae027","DOIUrl":"10.1093/jbi/wbae027","url":null,"abstract":"<p><strong>Objective: </strong>The use of artificial intelligence has potential in assisting many aspects of imaging interpretation. We undertook a prospective service evaluation from March to October 2022 of Mammography Intelligent Assessment (MIA) operating \"silently\" within our Breast Screening Service, with a view to establishing its performance in the local population and setting. This evaluation addressed the performance of standalone MIA vs conventional double human reading of mammograms.</p><p><strong>Methods: </strong>MIA analyzed 8779 screening events over an 8-month period. The MIA outcome did not influence the decisions made on the clinical pathway. Cases were reviewed approximately 6 weeks after the screen reading decision when human reading and/or MIA indicated a recall.</p><p><strong>Results: </strong>There were 146 women with positive concordance between human reading and MIA (human reader and MIA recalled) in whom 58 breast cancers were detected. There were 270 women with negative discordance (MIA no recall, human reader recall) for whom 19 breast cancers and 1 breast lymphoma were detected, with 1 cancer being an incidental finding at assessment. Six hundred and four women had positive discordance (MIA recall, human reader no recall) in whom 2 breast cancers were detected at review. The breast cancers demonstrated a wide spectrum of mammographic features, sites, sizes, and pathologies, with no statistically significant difference in features between the negative discordant and positive concordant cases.</p><p><strong>Conclusion: </strong>Of 79 breast cancers identified by human readers, 18 were not identified by MIA, and these had no specific features or site to suggest a systematic error for MIA analysis of 2D screening mammograms.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"378-387"},"PeriodicalIF":2.0,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141157168","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}
Lisa A Mullen, R Jared Weinfurtner, Kathy M Borovicka, Tamarya L Hoyt, Haley P Letter, Sophia R O'Brien, Nayanatara Swamy, Kerri L Vicenti, Stefanie A Woodard, Brian A Xavier, Kathleen R Gundry, Alex Merkulov, Laurie R Margolies, Priscilla J Slanetz
{"title":"Maximizing Mentorship Throughout Your Breast Imaging Career.","authors":"Lisa A Mullen, R Jared Weinfurtner, Kathy M Borovicka, Tamarya L Hoyt, Haley P Letter, Sophia R O'Brien, Nayanatara Swamy, Kerri L Vicenti, Stefanie A Woodard, Brian A Xavier, Kathleen R Gundry, Alex Merkulov, Laurie R Margolies, Priscilla J Slanetz","doi":"10.1093/jbi/wbae009","DOIUrl":"10.1093/jbi/wbae009","url":null,"abstract":"<p><p>Unlike many other subspecialties in radiology, breast radiologists practice in a patient-facing and interdisciplinary environment where team building, communication, and leadership skills are critical. Although breast radiologists can improve these skills over time, strong mentorship can accelerate this process, leading to a more successful and satisfying career. In addition to providing advice, insight, feedback, and encouragement to mentees, mentors help advance the field of breast radiology by contributing to the development of the next generation of leaders. During the mentorship process, mentors continue to hone their listening, problem-solving, and networking skills, which in turn creates a more supportive and nurturing work environment for the entire breast care team. This article reviews important mentorship skills that are essential for all breast radiologists. Although some of the principles apply to all mentoring relationships, ensuring that every breast radiologist has the skills to be both an effective mentor and mentee is key to the future of the profession.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"422-429"},"PeriodicalIF":2.0,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11288399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140330213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}