Journal of Breast Imaging最新文献

{"title":"Developing Financial Acumen as a Breast Imaging Radiologist.","authors":"Geraldine McGinty","doi":"10.1093/jbi/wbae035","DOIUrl":"10.1093/jbi/wbae035","url":null,"abstract":"<p><p>The economics of health care and payment policy are complex and continually evolving. Breast imaging radiologists may not feel equipped to understand the financial aspect of their practice, but this is a critical competency from residency to senior leadership, especially for breast imaging radiologists. From conducting effective negotiations for new equipment as technology evolves to understanding how insurance benefit design affects patient access to care, breast imaging radiologists need to grasp the financial structures that underpins their practice. Fortunately, resources exist that are appropriate for each career stage, and this article directs the breast imaging radiologist to those resources.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"668-672"},"PeriodicalIF":2.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421368","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":"The Role of Predeployment Retraction in Biopsy Marker Migration During Stereotactic Breast Biopsies: A Randomized Controlled Trial.","authors":"Noon Eltoum, Kathryn Zamora, Adrian Murray, John West, Joseph Willis, Angela Chieh, Yufeng Li, Mei Li, Jeong Mi Park, Stefanie Woodard","doi":"10.1093/jbi/wbae050","DOIUrl":"10.1093/jbi/wbae050","url":null,"abstract":"<p><strong>Objective: </strong>Inaccurate breast biopsy marker placement and marker migration during stereotactic biopsy procedures compromise their reliability for lesion localization and precise surgical excision. This trial evaluated the impact of 5-mm predeployment retraction of the marker introducer on marker migration, investigating other potential factors that influence the outcome.</p><p><strong>Methods: </strong>This parallel, randomized controlled trial enrolled women aged ≥18 years undergoing stereotactic breast biopsy at a single institution from May 2020 through August 2022. The study was approved by the institutional review board at the University of Alabama at Birmingham (UAB). Patients were randomized to intervention (5-mm introducer retraction before marker deployment) or control (standard marker placement) by drawing a labeled paper. The primary outcome was the distance of marker migration on immediate postprocedure mammogram.</p><p><strong>Results: </strong>Of 251 patients enrolled, 223 were analyzed; 104 received the intervention, and 119 received control. Mean (SD) marker migration was 12.1 (14.9) mm in the intervention group vs 9.8 (14.9) mm, with differences between groups estimated at 2.3 mm (SE = 1.9, P = .2312) (d = 0.16; 95% CI, 1.5-6.0). Effects of age, breast density, thickness, and biopsy approach showed no statistical significance. In exploratory models, central lesions exhibited 5.7 mm less migration than proximal lesions (95% CI, 0.7-10.6; P = .025), and each body mass index (BMI) unit increase was associated with 0.3 mm greater migration (95% CI, 0-0.6; P = .044).</p><p><strong>Conclusion: </strong>Retracting the marker introducer 5 mm before deployment did not reduce migration. Higher BMI and certain lesion locations were all associated with marker migration, highlighting the need to investigate biomechanical factors and techniques to optimize breast marker placement.Clinical Trials Registration: NCT04398537.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"610-620"},"PeriodicalIF":2.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141340","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}

{"title":"Tips and Tricks for Image-Guided Breast Biopsies: Technical Factors for Success.","authors":"Katerina Dodelzon, Lars Grimm, Kristen Coffey, Beatriu Reig, Lisa Mullen, Brittany Z Dashevsky, Sonya Bhole, Jay Parikh","doi":"10.1093/jbi/wbae055","DOIUrl":"10.1093/jbi/wbae055","url":null,"abstract":"<p><p>Image-guided biopsy is an integral step in the diagnosis and management of suspicious image-detected breast or axillary lesions, allowing for accurate diagnosis and, if indicated, treatment planning. Tissue sampling can be performed under guidance of a full spectrum of breast imaging modalities, including stereotactic, tomosynthesis, sonographic, and MRI, each with its own set of advantages and limitations. Procedural planning, which includes consideration of technical, patient, and lesion factors, is vital for diagnostic accuracy and limitation of complications. The purpose of this paper is to review and provide guidance for breast imaging radiologists in selecting the best procedural approach for the individual patient to ensure accurate diagnosis and optimal patient outcomes. Common patient and lesion factors that may affect successful sampling and contribute to postbiopsy complications are reviewed and include obesity, limited patient mobility, patient motion, patients prone to vasovagal reactions, history of anticoagulation, and lesion location, such as proximity to vital structures or breast implant.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"658-667"},"PeriodicalIF":2.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308700","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}

{"title":"Severe Adverse Event Related to Holding Antithrombotic Therapy Before Breast Biopsy.","authors":"Heather Garrett, Debbie Bennett","doi":"10.1093/jbi/wbad090","DOIUrl":"10.1093/jbi/wbad090","url":null,"abstract":"","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"693-696"},"PeriodicalIF":2.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477139","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: Implant Protocol Breast MRI-Looking Beyond the Implants.","authors":"Molly Hill, Allison Aripoli","doi":"10.1093/jbi/wbae067","DOIUrl":"https://doi.org/10.1093/jbi/wbae067","url":null,"abstract":"","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509996","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: Incidental Rib Lesion in a Breast Cancer Survivor.","authors":"Catherine Yee Man Young, Suet-Mui Yu","doi":"10.1093/jbi/wbae068","DOIUrl":"https://doi.org/10.1093/jbi/wbae068","url":null,"abstract":"","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509997","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":"Secretory Carcinoma of the Breast: Radiologic-Pathologic Correlation.","authors":"Pamela Boustros, Lilia Maria Sanchez, Louis Gaboury, Mona El Khoury","doi":"10.1093/jbi/wbae041","DOIUrl":"https://doi.org/10.1093/jbi/wbae041","url":null,"abstract":"<p><p>Secretory carcinoma is a rare, low-grade, special histological type of invasive breast carcinoma. Although it is the most common primary breast cancer in the pediatric population, most cases are diagnosed in adults, with a median age of 48 years (range 3 to 91 years). It most often presents as a painless and slowly growing palpable lump. Imaging findings are nonspecific. Secretory carcinomas have abundant periodic acid-Schiff positive intracytoplasmic and extracellular secretions on histopathology. Nearly all secretory carcinomas have mild to moderate nuclear pleomorphism with low mitotic activity. Over 80% (86/102) of secretory carcinomas display the translocation of t(12;15)(p13;q25), resulting in ETV6::NTRK3 gene fusion. Secretory carcinoma generally has an indolent course and has a better prognosis and overall survival than invasive breast carcinoma of no special type. A good prognosis is associated with age <20 years, tumor size <2 cm, and ≤3 axillary lymph node metastases. Metastases beyond the ipsilateral axillary lymph nodes are rare, with the most common sites involving the lung and liver. Except for the potential addition of targeted drug therapy for NTRK fusion-positive tumors, the treatment approach is otherwise similar to invasive breast carcinomas of similar receptor status.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":"6 5","pages":"520-528"},"PeriodicalIF":2.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297990","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":"SCOUT® Localization Using MRI Guidance: Initial Experience.","authors":"Brittany Z Dashevsky, Pamela Yan, Tie Liang, Bruce L Daniel","doi":"10.1093/jbi/wbae025","DOIUrl":"10.1093/jbi/wbae025","url":null,"abstract":"<p><strong>Objective: </strong>The Food and Drug Administration approved the MRI-compatible wireless SCOUT localization system in April 2022. The purpose of this study was to evaluate feasibility of SCOUT localization under MRI guidance. We present our initial experience adopting MRI-guided SCOUT localization and compare it to MRI-guided wire localization.</p><p><strong>Methods: </strong>Electronic medical records and imaging were retrospectively reviewed for all patients who underwent MRI-guided SCOUT or wire localization at our institution between October 2022 and July 2023. Statistical analysis was performed using 2-sample proportion and Wilcoxon rank-sum tests.</p><p><strong>Results: </strong>There were 14 MRI-guided SCOUT and 23 MRI-guided wire localization cases during the study period. All SCOUTs were placed without complication and were considered to be in adequate proximity to the target. There was no significant difference in complication rate (P = .25) or days lapsed from MRI-detected abnormality to surgery (P = .82) between SCOUT and wire cases. SCOUT was placed at time of biopsy for 71% (10/14) of cases. 57% (8/14) of SCOUT cases were used for breast conservation surgery (BCS) compared to 100% (23/23) of wire cases (P <.01), with all 6 SCOUTs not used for BCS placed at time of biopsy.</p><p><strong>Conclusion: </strong>MRI-guided SCOUT localization is feasible and offers an alternative to MRI-guided wire localization, with no SCOUT complications reported. SCOUT placement at time of biopsy obviates the need for an additional procedure, but predicting appropriateness is challenging, with 60% (6/10) of SCOUTs placed at time of MRI-guided biopsy not used for subsequent localization surgery.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"476-484"},"PeriodicalIF":2.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248700","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":"The Use of Breast-specific Gamma Imaging as a Low-Cost Problem-Solving Strategy for Avoiding Biopsies in Patients With Inconclusive Imaging Findings on Mammography and Ultrasonography.","authors":"Andrew Ko, Alexander M Vo, Nathaniel Miller, Annie Liang, Maia Baumbach, Jay Riley Argue, Nathaniel Manche, Luis Gonzalez, Nicholas Austin, Philip Carver, Joseph Procell, Hassan Elzein, Margaret Pan, Nadine Zeidan, William Kasper, Samuel Speer, Yizhi Liang, Benjamin J Pettus","doi":"10.1093/jbi/wbae040","DOIUrl":"10.1093/jbi/wbae040","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical performance and financial costs of breast-specific gamma imaging (BSGI) as a biopsy-reducing problem-solving strategy in patients with inconclusive diagnostic imaging findings.</p><p><strong>Methods: </strong>A retrospective analysis of all patients for whom BSGI was utilized for inconclusive imaging findings following complete diagnostic mammographic and sonographic evaluation between January 2013 and December 2018 was performed. Positive BSGI findings were correlated and biopsied with either US or stereotactic technique with confirmation by clip location and pathology. After a negative BSGI result, patients were followed for a minimum of 24 months or considered lost to follow-up and excluded (22 patients). Results of further imaging studies, biopsies, and pathology results were analyzed. Net savings of avoided biopsies were calculated based on average Medicare charges.</p><p><strong>Results: </strong>Four hundred and forty female patients from 30 to 95 years (mean 55 years) of age were included in our study. BSGI demonstrated a negative predictive value (NPV) of 98.4% (314/319) and a positive predictive value for biopsy of 35.5% (43/121). The overall sensitivity was 89.6% (43/48), and the specificity was 80.1% (314/392). In total, 78 false positive but only 5 false negative BSGI findings were identified. Six hundred and twenty-one inconclusive imaging findings were analyzed with BSGI and a total of 309 biopsies were avoided. Estimated net financial savings from avoided biopsies were $646 897.</p><p><strong>Conclusion: </strong>In the management of patients with inconclusive imaging findings on mammography or ultrasonography, BSGI is a problem-solving imaging modality with high NPV that helps avoid costs of image-guided biopsies.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"502-512"},"PeriodicalIF":2.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005483","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":"Tips for Addressing Screening Concerns: \"Harms of Screening\".","authors":"Angela I Choe, Emel Kaya Aumann, Claudia Kasales, Alison Chetlen, Rebecca Sivarajah","doi":"10.1093/jbi/wbae031","DOIUrl":"10.1093/jbi/wbae031","url":null,"abstract":"<p><p>Early detection decreases deaths from breast cancer. Yet, there are conflicting recommendations about screening mammography by major professional medical organizations, including the age and frequency with which women should be screened. The controversy over breast cancer screening is centered on 3 main points: the impact on mortality, overdiagnosis, and false positive results. Some studies claim that adverse psychological effects such as anxiety or distress are caused by screening mammography. The purpose of this article is to address negative breast cancer screening concerns including overdiagnosis and overtreatment, effect on mortality, false positive results, mammography-related anxiety, and fear of radiation.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"457-464"},"PeriodicalIF":2.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141157251","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}