Seminars in breast disease最新文献

{"title":"What’s Important to the Radiologist and Patient","authors":"Margarita Zuley MD","doi":"10.1053/j.sembd.2006.08.007","DOIUrl":"10.1053/j.sembd.2006.08.007","url":null,"abstract":"<div><p>This chapter provides an overview of factors important from a patient’s perspective during a visit to the mammography department, with emphasis on the effects to clinical practice, as well as discussion of what helps the radiologist in the interpretation of both screen film and digital mammograms. Identification of adjustments and changes necessary in the transition to digital imaging is provided in addition to descriptions of additional and special views. Explanations of methods to image the difficult body habitus are also covered.</p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"8 4","pages":"Pages 198-205"},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2006.08.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57938059","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":"Within the Smorgasbord of Women’s Imaging, Do We Need to Improve Our Bone Appétit?","authors":"Florence C. Gellman R.T.(R)(M)(BD)RDMS(BR)CDT","doi":"10.1053/j.sembd.2006.08.006","DOIUrl":"10.1053/j.sembd.2006.08.006","url":null,"abstract":"<div><p><span>Bone Densitometry (DXA) has become an imaging tool used to screen and treat women for osteoporosis with a frequency approaching that of the screening </span>mammogram. In fact, they are often exams that are ordered in tandem. As was once the case with mammography, we are now beginning to discover that we need to improve our technique and possibly insist on further education and certification for those who perform and interpret DXA exams. Should the industry strive to standardize scan acquisition and analyses software to make intermanufacterer comparisons not only possible but accurately comparable? A need for Quality Assurance Program standardization is evident in the lack of facilities performing basic Quality Control testing of the unit and technologist precision studies on a regular basis. As proven in a study in 2004, there is also room for improvement in the understanding, scanning, interpreting, and reporting of pediatric bone densitometry. It seems that a standardized Quality Assurance Program is needed by a central governing body perhaps ISCD (The International Society for Clinical Densitometry). ISCD is going to begin offering Facility Accreditation for those performing these skeletal assessments. It will assess every element involved in performing DXA exams, from the qualifications of personnel to quality control testing, scan acquisition, scan analyses, interpretation, and reporting. What will become optional in the Fall of 2006 may one day be mandated as was mammography if we don’t get our bones in order.</p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"8 4","pages":"Pages 211-214"},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2006.08.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57938052","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":"Mammography Positioning: The CC and MLO","authors":"Diane Rinella RT (R) (M) (BD) RDMS (BR) CDT","doi":"10.1053/j.sembd.2006.08.005","DOIUrl":"10.1053/j.sembd.2006.08.005","url":null,"abstract":"<div><p>The American College of Radiology (ACR) instituted a volunteer accreditation process for mammography facilities which began in 1987. The college paved the way for MQSA regulations, which all facilities in the United States are now regulated by. There are many criteria required for a mammography facility to be accredited. Clinical image review is one of those criteria. Although mammography patient positioning is the one element that is practiced most frequently, it is the one criteria that is shown to be most deficient. A thorough review of proper positioning of the craniocaudal and mediolateral oblique views for the screening mammography patient will be discussed in detail.</p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"8 4","pages":"Pages 206-210"},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2006.08.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57938036","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":"Quality Control for Technologists in Digital Mammography","authors":"Eric A. Berns PhD","doi":"10.1053/j.sembd.2006.08.002","DOIUrl":"10.1053/j.sembd.2006.08.002","url":null,"abstract":"<div><p>As of June 2006, there are 6 FDA-approved full-field digital mammography systems available for clinical use in the U.S. Each of these systems has a quality control program supplied by the manufacturer that sites must follow to satisfy FDA regulations. These tests are written to be similar to the quality control tests for screen-film mammography, but have differences due to the nature and physics of the digital detector, the soft-copy review workstation, and overall system design. These differences will be discussed in this paper as well as the requirements for performing quality control in digital mammography. Additionally, this document includes a section on tips and tricks that are not found in manufacturer’s quality control manuals.</p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"8 4","pages":"Pages 192-197"},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2006.08.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57938161","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":"Implementation of Full-Field Digital Mammography: A Technologist’s Perspective","authors":"Carol J. Mount R.T.(R)(M),&nbsp;Kathleen R. Brandt MD,&nbsp;Beth A. Schueler PhD,&nbsp;Toni L. Allhiser R.T.(R)(M)","doi":"10.1053/j.sembd.2006.08.003","DOIUrl":"10.1053/j.sembd.2006.08.003","url":null,"abstract":"<div><p>Full-field digital mammography (FFDM) is affecting the way breast imaging centers work. The reports of gained efficiencies in workflow by operating in a cassetteless and filmless environment are intriguing and taunt analog users. The gained efficiencies, however, do not come without a price. The price is not only the increased cost of equipment, but also the added stress of the implementation process. Being prepared for the experience is important to avoid unexpected problems and undue stress. The purpose of this article is to help the reader understand what to expect during the implementation of an FFDM unit. The key factors for a smooth transition from analog to digital are preplanning with a team approach, mapping out workflow to completely understand each step in the process, and fully understanding the benefits and limitations of the system.</p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"8 4","pages":"Pages 185-191"},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2006.08.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57938236","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":"Neoadjuvant Chemotherapy: Mammographic–Pathologic Correlation","authors":"Julio A. Ibarra MD ,&nbsp;Angela Sie MD ,&nbsp;John S. Link MD ,&nbsp;Richard Reitherman MD","doi":"10.1053/j.sembd.2006.07.004","DOIUrl":"10.1053/j.sembd.2006.07.004","url":null,"abstract":"<div><p><span><span>The use of neoadjuvant chemotherapy (NACT) or neoadjuvant systemic therapy (NST) for breast cancers has increased significantly. NACT is, by definition, utilized, before surgery and before radiation therapy. The idea behind this type of treatment is to be able to eradicate potential systemic micrometastatic foci and produce shrinkage of the primary tumor. Some cases are treated to convert </span>inoperable cancers into operable ones; other cases are treated to allow breast conservation. One of the concerns with the use of NACT is a reported increase in local recurrence after </span>breast conserving surgery. It is therefore critical for accuracy of results and margin evaluation that the radiologic and pathologic evaluations are performed in an interdisciplinary forum. Evaluation of the imaging studies in conjunction with the pathologic information provides the most accurate information regarding residual versus no residual disease.</p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"8 3","pages":"Pages 163-175"},"PeriodicalIF":0.0,"publicationDate":"2005-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2006.07.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57937538","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":"Mammographic–Pathologic Correlation in Core Biopsies of the Breast","authors":"Chandandeep Nagi MD,&nbsp;Shabnam Jaffer MD,&nbsp;Ira J. Bleiweiss MD","doi":"10.1053/j.sembd.2006.07.002","DOIUrl":"10.1053/j.sembd.2006.07.002","url":null,"abstract":"<div><p>New advances in breast imaging have changed the way we manage breast cancer. Core biopsies (ultrasound and/or stereotactic guided) provide an easy, cost effective method of diagnosing breast cancer. They are often the primary means of rendering an initial diagnosis. The increasing numbers of core biopsies being seen by the routine pathology practice along with the inherently smaller amount of tissue available presents challenges to pathologic interpretation. By correlating the radiologic picture with the histologic diagnosis, these obstacles can be mastered furnishing a more accurate and specific diagnosis and in the end improving patient care.</p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"8 3","pages":"Pages 138-143"},"PeriodicalIF":0.0,"publicationDate":"2005-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2006.07.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57937853","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":"Mammographic–Pathologic Correlation of Ductal Carcinoma In Situ of the Breast Using Two- and Three-Dimensional Large Histologic Sections","authors":"Tibor Tot MD, PhD ,&nbsp;László Tabár MD, FACR (Hon)","doi":"10.1053/j.sembd.2006.07.007","DOIUrl":"10.1053/j.sembd.2006.07.007","url":null,"abstract":"<div><p><span><span><span>Specially adapted histology techniques (two- and three-dimensional large sections) and systematic radiologic-pathologic correlation of the findings facilitate the understanding of ductal carcinoma in situ<span> (DCIS), a heterogeneous and progressive group of diseases. DCIS cases can be classified as special and non-special types both mammographically and histologically. The mammographic special forms are the non-calcified DCIS cases (dominant mass, galactography findings and architectural distortion). The mammographic special forms are the cases containing </span></span>microcalcifications. In this review, the histologic distinction of special versus non-special forms of DCIS will be used. According to this, the special type of DCIS includes intracystic and intraductal </span>papillary carcinomas<span>, tumor forming DCIS, Paget’s disease and other lesions while the non-special types of DCIS involves the lobules and the ducts of the breast. The special type DCIS cases are unifocal in 65%. In the majority (60%) of cases, DCIS of non-special type involves the lobules and disturbs the normal process of lobularization leading to development of well circumscribed, unifocal, or multifocal lesions, most often of low or intermediate histological grade. These lesions calcify in 80% of cases and manifest as clusters of powdery or crushed stone-like microcalcifications on the mammogram. Lesions involving the larger ducts develop a diffuse network of tubes, which is difficult to delineate or measure. The radiological hallmark of these cases is the presence of casting-type microcalcifications. In a considerable number of diffuse cases (almost exclusively high-grade) neoductgenesis can be observed as a sign of disturbed arborisation of the ductal system, which is regularly associated with signs of altered epithelial-stromal interaction (periductal fibrosis and </span></span>lymphocytic infiltration<span> as well as remodeling of the periductal stroma). The majority of cases in DCIS non-special type are multifocal or diffuse, and more than half of them are extensive (involving a larger area than 2 cm in diameter). Extensive DCIS cases with signs of neoductgenesis recur significantly more often than the rest. Micropapillary DCIS, especially if high-grade, is an extensive disease, which frequently recurs. The individual lesions in DCIS seem to be confined to a single sick lobe within the breast. An imaging method able to demonstrate the diseased lobe would be needed to remove DCIS in its entirety and prevent recurrences.</span></p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"8 3","pages":"Pages 144-151"},"PeriodicalIF":0.0,"publicationDate":"2005-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2006.07.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57937447","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":"Enhancement of Mammographic–Pathologic Correlation Utilizing Large Format Histology for Malignant Breast Disease","authors":"Karl W. Biesemier MD ,&nbsp;M. Camille Alexander MD","doi":"10.1053/j.sembd.2006.07.005","DOIUrl":"10.1053/j.sembd.2006.07.005","url":null,"abstract":"<div><p><span>The use of large format histology in the pathological examination of breast specimens offers many advantages over traditional histological processing, one of which is enhanced radiologic–pathologic correlation. The utility of this technique in malignant breast disease with emphasis on those lesions presenting with a mass or architectural distortion on breast imaging will be discussed. We have utilized the large format histology technique in our independent pathology laboratory servicing a two-campus community hospital system in Lynchburg, VA for 6 years, incorporating it into our routine handling of excisional breast specimens since early 2000. In the period from March 2000 to March 2006, we have processed 1091 blocks from 618 breast cancer cases. This includes 19% of all infiltrating </span>ductal carcinomas<span><span>, 25% of all invasive lobular carcinomas, and 43% of all cases of pure </span>ductal carcinoma in situ diagnosed in Lynchburg during the period.</span></p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"8 3","pages":"Pages 152-162"},"PeriodicalIF":0.0,"publicationDate":"2005-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2006.07.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57937618","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":"Excisional Breast Specimen Orientation/Processing: A Multidisciplinary Approach for Breast Conservation","authors":"Sheldon M. Feldman MD, FACS ,&nbsp;Edna K. Valdes MD ,&nbsp;Susan K. Boolbol MD ,&nbsp;Jean-Marc Cohen MD ,&nbsp;Joshua Gross MD","doi":"10.1053/j.sembd.2006.07.003","DOIUrl":"10.1053/j.sembd.2006.07.003","url":null,"abstract":"<div><p>Breast carcinoma is the most frequently diagnosed malignancy in women of North America. The combination of breast conservation surgery and radiotherapy has become a standard of treatment for the majority of breast cancers. It is critical to obtain clear margins to minimize local recurrence. However avoiding multiple re-excisions for margin clearance helps optimize cosmetic results in patients undergoing breast conservation surgery. Careful attention to the details of peri-operative evaluation and management are critical for success. The objective of this article is to define safe and effective techniques of preoperative planning and intraoperative breast specimen orientation and processing. The importance of a multidisciplinary approach with excellent communication between team members is stressed. Accurate pre-operative diagnosis, precise localization of the area of concern, volume of the surgical excision, specimen orientation, specimen radiography, intraoperative margin evaluation, specimen inking, and pathology processing are discussed. The specifics of the policy for breast specimen handling will vary depending on the resources and expertise available at each treating facility. This paper describes the approach used at Beth Israel Medical Center.</p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"8 3","pages":"Pages 121-126"},"PeriodicalIF":0.0,"publicationDate":"2005-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2006.07.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57937432","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}