{"title":"Breast MRI-Directed Intervention: Localization, Biopsy, and Treatment","authors":"Steven E. Harms MD, FACR , Sally S. Harms MD, JD","doi":"10.1053/j.sembd.2008.03.003","DOIUrl":"10.1053/j.sembd.2008.03.003","url":null,"abstract":"<div><p>Since breast magnetic resonance imaging (MRI) can identify lesions not seen on other imaging methods, MRI-directed biopsy and localization is a necessary part of a breast MRI practice. A wide variety of MRI-compatible localization wires, localization markers, biopsy needles<span>, and vacuum-assisted biopsy devices are available. The attributes of each device are described. Stereotactic guidance systems are now produced that will accommodate almost any current MRI system. Dedicated breast MRI systems with full integration of interventional capability are now available. The superior definition of lesion extent by MRI may allow the minimally invasive treatment of breast cancer in the future.</span></p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"11 2","pages":"Pages 88-99"},"PeriodicalIF":0.0,"publicationDate":"2008-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2008.03.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57943284","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":"Diagnostic Applications of Breast MRI","authors":"Elsie Levin MD","doi":"10.1053/j.sembd.2008.04.013","DOIUrl":"10.1053/j.sembd.2008.04.013","url":null,"abstract":"<div><p><span>The current diagnostic applications of breast MRI, which include staging of the newly diagnosed breast cancer patient, monitoring of </span>neoadjuvant chemotherapy, and identifying mammographically occult tumors, are reviewed. Contrast-enhanced breast MRI is also useful in the evaluation of ambiguous clinical and imaging findings.</p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"11 2","pages":"Pages 76-87"},"PeriodicalIF":0.0,"publicationDate":"2008-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2008.04.013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57943957","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":"Breast MRI Screening for High-Risk Patients","authors":"Alan B. Hollingsworth MD , Rebecca G. Stough MD","doi":"10.1053/j.sembd.2008.03.002","DOIUrl":"10.1053/j.sembd.2008.03.002","url":null,"abstract":"<div><p>Although mammography<span> can reduce breast cancer mortality rates in screened populations, its modest sensitivity, especially in younger women with strong family histories for breast cancer, has prompted the introduction of breast magnetic resonance imaging (MRI) for high-risk screening. Seven prospective screening trials for high-risk patients in which MRI has been added to mammography indicate the sensitivity of MRI to be twice that of mammography alone. The specificity of MRI is lower than mammography in most, but not all studies; however, the specificity of MRI improves to a level comparable to mammography in screenings subsequent to the initial prevalence screen. Although the target populations in breast MRI screening studies have been identified by genetic and familial risks, the superior sensitivity of MRI has been demonstrated at all levels of elevated risk, raising the possibility that MRI screening could benefit women with risk factors other than a positive family history. The published studies on breast MRI screening are reviewed herein, along with new screening guidelines that are currently shaping practice patterns.</span></p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"11 2","pages":"Pages 67-75"},"PeriodicalIF":0.0,"publicationDate":"2008-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2008.03.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57943143","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":"Breast Health Navigator: A Paradigm Shift in Breast Health Care","authors":"Judy C. Kneece RN, OCN","doi":"10.1053/j.sembd.2008.04.004","DOIUrl":"10.1053/j.sembd.2008.04.004","url":null,"abstract":"<div><p><span><span>In the 1990s, radical health care reforms forced many standard inpatient care procedures to an outpatient setting. Breast cancer patients, once hospitalized for days following surgery, were discharged almost immediately. Nurses no longer had time to teach patients self-care skills for recovery. A chasm in the nurse/patient relationship resulted, necessitating a paradigm shift in nursing delivery for breast cancer patients. The Breast Health Navigator—bridging the gap within the nurse/patient relationship in an outpatient setting—extends education and support throughout the continuum of illness. Because the majority of patient recovery skills required for positive outcomes are sensitive to nursing education, this new expanded role encompasses teaching physical self-care skills, psychological support and </span>anticipatory guidance<span>, physical and psychological assessment for triage to physicians or ancillary support systems, and psychosocial support in preparation for the challenges of </span></span>survivorship<span>. The navigator is a focal point of contact for the patient, simplifying a complex medical maze that often includes up to five physicians and coaching the patient to work as an informed partner with her health care team. Care is defragmented, productivity is increased in the physician/patient relationship, and the locus of control is returned to the patient, which is necessary for complete recovery. Based on philosophy of care delivery organization, not on equipment, the Breast Health Navigator model has proven successful for breast centers of all sizes. Lexington Medical Center serves as a case study (see pages 20). Research study of roles and responsibilities of nurses working in breast centers is included (see pages 21).</span></p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"11 1","pages":"Pages 13-19"},"PeriodicalIF":0.0,"publicationDate":"2008-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2008.04.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57943717","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":"Nurses at the Center: Roles of Nurses in Breast Centers","authors":"","doi":"10.1053/j.sembd.2008.04.006","DOIUrl":"https://doi.org/10.1053/j.sembd.2008.04.006","url":null,"abstract":"","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"11 1","pages":"Pages 21-25"},"PeriodicalIF":0.0,"publicationDate":"2008-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2008.04.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138217605","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":"Guest Editoral: Prospective Treatment Planning, Nurse Navigation, Breast Center Development, Multidisciplinary Breast Clinic, and Community Outreach","authors":"Claudia Z. Lee MBA (Guest Editor)","doi":"10.1053/j.sembd.2008.04.012","DOIUrl":"10.1053/j.sembd.2008.04.012","url":null,"abstract":"","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"11 1","pages":"Pages 1-3"},"PeriodicalIF":0.0,"publicationDate":"2008-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2008.04.012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57943929","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 Janice Beesley Hartvigsen Breast Care Center at Intermountain Medical Center: The Path from Vision to Realization","authors":"Brett T. Parkinson MD","doi":"10.1053/j.sembd.2008.04.009","DOIUrl":"10.1053/j.sembd.2008.04.009","url":null,"abstract":"","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"11 1","pages":"Pages 35-37"},"PeriodicalIF":0.0,"publicationDate":"2008-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2008.04.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57943563","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":"Multidisciplinary Breast Clinic: A Team Effort","authors":"Dianne Kane RN, Brett T. Parkinson MD","doi":"10.1053/j.sembd.2008.04.008","DOIUrl":"10.1053/j.sembd.2008.04.008","url":null,"abstract":"<div><p><span>The coordination of treatment for the newly diagnosed breast cancer patient can be challenging, especially in a private </span>health care system. The process begins with an effective imaging program, built on trust and seamless coordination among breast radiologists, referring clinicians, and treating physicians. Once the imaging component is in place and a multidisciplinary breast conference has been established, the next logical step is to bring the patient together with a group of medical experts in a clinic setting to discuss her case. This Multidisciplinary Breast Clinic model facilitates direct communication between the multidisciplinary breast conference participants and the patient. In addition to increasing patient satisfaction, the clinic—if appropriately presented to the community—also has the potential of directing additional patients into the system for treatment. All medical specialties involved in the treatment of breast cancer, including many ancillary and support providers, come together to consult with the patient in a “one-stop shopping” appointment. The purpose of the clinic is not just to provide a treatment plan but also to educate and offer support. It also assures the patient that her providers are communicating with one another regarding her treatment. This type of service, in addition to being the right thing to do, sets a health care system apart in the competitive cancer care market.</p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"11 1","pages":"Pages 31-35"},"PeriodicalIF":0.0,"publicationDate":"2008-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2008.04.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57943502","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 Efficacy of the Nurse Navigator in a Community Hospital Breast Care Program","authors":"Susan C. Bowman RN, BS, OCN, MSW , Rod D. Grim MA","doi":"10.1053/j.sembd.2008.04.007","DOIUrl":"10.1053/j.sembd.2008.04.007","url":null,"abstract":"<div><p><span><span>Breast cancer patients receive multimodality treatment and are informed consumers with high expectations. The breast </span>oncology<span> nurse navigator has become an integral part of the health care team. The navigator responds to individual patient needs by tailoring intervention to personal requirements and facilitating care coordination. This study questioned whether breast cancer patients using navigator services believed them to be helpful, to what degree they thought them helpful, and what they liked or disliked about the program. In a cohort of 530 respondents, 96% stated that the navigator program was helpful compared with 4% who found the program not helpful (</span></span><em>P</em> < 0.05). The study ascribed a mean helpfulness score of 9.28 of 10 to the navigator program. An analysis of quantitative data indicated a high level of patient value on individualized support, education, advocacy, and care coordination.</p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"11 1","pages":"Pages 26-30"},"PeriodicalIF":0.0,"publicationDate":"2008-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2008.04.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57943391","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":"Putting Breast Health First: Establishing No-Cost Comprehensive Breast Care for the Indigent and Underinsured Requires a Well-Orchestrated Community Collaboration","authors":"Renea Duffin MPA","doi":"10.1053/j.sembd.2008.04.011","DOIUrl":"10.1053/j.sembd.2008.04.011","url":null,"abstract":"<div><p><span>Mary Bird Perkins Cancer Center's unique CARE Network in Baton Rouge, Louisiana, is used as a best-practice model to illustrate what can be achieved when breast cancer care facilities set aside politics and collaborate to put women's breast health needs first. How the CARE Network, working in partnership with other health care agencies, was established to meet a regional need and how it has maximized various funding sources to provide free mobile </span>mammography and comprehensive breast cancer services to an uninsured and underinsured population is described. The essential services required to reach and treat this population to help lower the rate of breast cancer deaths in a state which has one of the highest cancer mortality rates in the country are delineated.</p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"11 1","pages":"Pages 43-47"},"PeriodicalIF":0.0,"publicationDate":"2008-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2008.04.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57943758","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}