{"title":"Computed Radiography for Mammography: Operational Perspectives","authors":"R. James Brenner MD","doi":"10.1053/j.sembd.2006.12.003","DOIUrl":"10.1053/j.sembd.2006.12.003","url":null,"abstract":"<div><p>Computed radiography represents an approach to full-field digital mammography in which, unlike direct radiography (DR), a latent image is physically transferred to an image reader for processing and interpretation. The approach is applicable to existing mammographic and other radiographic units. Costs and operation applications are more variable than DR.</p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"9 2","pages":"Pages 58-61"},"PeriodicalIF":0.0,"publicationDate":"2006-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2006.12.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57938862","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}
Jay R. Parikh MD, FRCP(c), CPE, FSBI, FACPE , Priscilla F. Butler MS, FACR, FAAPM
{"title":"Full-Field Digital Mammography Quality Control: Operational Considerations","authors":"Jay R. Parikh MD, FRCP(c), CPE, FSBI, FACPE , Priscilla F. Butler MS, FACR, FAAPM","doi":"10.1053/j.sembd.2006.12.004","DOIUrl":"10.1053/j.sembd.2006.12.004","url":null,"abstract":"<div><p>Full-field digital mammography<span> (FFDM) is gaining widespread clinical acceptance in the United States and has the potential to ultimately replace screen-film mammography (SFM). Since the introduction of the MQSA in 1992 by the US Congress, studies have demonstrated that, with increased attention to quality control, SFM has improved in quality across the United States. For FFDM to phase out and ultimately replace SFM, similar stringent quality control processes will be required of FFDM. The purpose of this article is to outline operational considerations during the implementation of FFDM quality control in a breast imaging facility.</span></p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"9 2","pages":"Pages 62-69"},"PeriodicalIF":0.0,"publicationDate":"2006-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2006.12.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57938397","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}
Margarita Zuley MD , Jay R. Parikh MD, FRCP(c), CPE, FSBI, FACPE
{"title":"Full-Field Digital Mammography Workflow","authors":"Margarita Zuley MD , Jay R. Parikh MD, FRCP(c), CPE, FSBI, FACPE","doi":"10.1053/j.sembd.2006.12.005","DOIUrl":"10.1053/j.sembd.2006.12.005","url":null,"abstract":"<div><p>Within the United States, breast centers are actively transitioning from screen-film mammography to full-field digital mammography. Mammography departments can take many lessons from the rest of radiology when considering the conversion from analog to digital imaging. Just as in the rest of radiology, understanding and planning for the workflow changes that will occur are critical to a seamless conversion. This transition will affect all aspects of patient care in the department, and must be done within the fiscal limitations confronting breast centers. To a large degree, the workflow is dependent on the equipment that is purchased. The purpose of this article is to outline critical operational workflow considerations during the transition to full-field digital mammography.</p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"9 2","pages":"Pages 70-74"},"PeriodicalIF":0.0,"publicationDate":"2006-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2006.12.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57938526","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}
Deborah J. MacDonald , Sharon Sand , Frederic Kass , Kathleen R. Blazer , Jane Congleton , John Craig , Jeffrey N. Weitzel
{"title":"The Power of Partnership: Extending Comprehensive Cancer Center Expertise in Clinical Cancer Genetics to Community Breast Care Centers","authors":"Deborah J. MacDonald , Sharon Sand , Frederic Kass , Kathleen R. Blazer , Jane Congleton , John Craig , Jeffrey N. Weitzel","doi":"10.1053/j.sembd.2006.10.001","DOIUrl":"10.1053/j.sembd.2006.10.001","url":null,"abstract":"<div><p><span>Although many academic medical centers provide comprehensive genetic cancer risk assessment (GCRA) services, most people receive their medical care in the community setting. Consequently, the City of Hope Comprehensive Cancer Center in Southern California developed a hub and spoke </span><em>Cancer Screening & Prevention Program Network<sup>sm</sup></em><span> (CSPPN) to facilitate the delivery of state of the art GCRA services in dispersed communities. Growth of the CSPPN and innovation in technical support was catalyzed by education research grants and a technology transfer grant. An extended informatics technology-enabled network strategy was crafted, wherein community-based breast centers contract with the Cancer Center for program development, specialized training for personnel and ongoing support for quality care, and continuing medical education for community clinicians. Technology and collaboration are a powerful way to extend GCRA expertise from a NCI-designated Comprehensive Cancer Center to community breast centers, with a net effect of increased access to expertise and enhanced community-based research.</span></p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"9 1","pages":"Pages 39-47"},"PeriodicalIF":0.0,"publicationDate":"2006-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2006.10.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57938075","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 Cancer Ablation: Current Status 2006","authors":"Cary S. Kaufman MD, FACS","doi":"10.1053/j.sembd.2006.10.004","DOIUrl":"10.1053/j.sembd.2006.10.004","url":null,"abstract":"<div><p><span>The decrease in average size of breast cancer at presentation has spurred interest into less invasive forms of local treatment. Techniques to ablate breast cancer within the breast without surgery are being studied in many countries. Interdisciplinary comprehensive breast centers strive to keep current with new technologies such as ablation. The goal of these efforts is to destroy the breast cancer effectively with minimally invasive methods and in a patient-friendly manner. Current methods of breast </span>cancer ablation are reviewed and compared in effectiveness, ease of use, cost, discomfort, and existing published data. A major hurdle for all methods is to identify proper candidates for targeted ablation. When pretreatment imaging identifies truly unifocal breast cancers, one or more of these methods will be ready to treat these small unifocal cancers effectively.</p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"9 1","pages":"Pages 3-12"},"PeriodicalIF":0.0,"publicationDate":"2006-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2006.10.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57938279","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}
John S. Link , Jane L. Kakkis , Richard Reitherman , Julio A. Ibarra , Cheryl I. Jacobs
{"title":"Neoadjuvant Therapy: The Ultimate Interdisciplinary Challenge","authors":"John S. Link , Jane L. Kakkis , Richard Reitherman , Julio A. Ibarra , Cheryl I. Jacobs","doi":"10.1053/j.sembd.2006.10.002","DOIUrl":"10.1053/j.sembd.2006.10.002","url":null,"abstract":"<div><p>The modern treatment of breast cancer requires a collaborative, interdisciplinary approach. This is particularly the case with the use of neoadjuvant systemic therapy (NST). Optimal treatment requires participating physicians to have well-defined roles and “shared protocols” to follow. Interdisciplinary prospective conferences provide the forum for treatment planning and ongoing assessment. NST allows less surgery, gives important prognostic information, and is a valuable clinical research approach. With the better selection of patients for neoadjuvant therapy and with the advent of more effective systemic treatments, the extent of surgery and radiation necessary for adequate local control will need to be determined. The use of neoadjuvant therapy in breast cancer as part of a combined multimodality approach has become well established. It requires an organizational framework that facilitates the various oncology specialists working together toward a common goal of optimal treatment.</p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"9 1","pages":"Pages 13-18"},"PeriodicalIF":0.0,"publicationDate":"2006-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2006.10.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57938112","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":"New Directions in Radiation for Breast Conserving Therapy in Early Stage Breast Cancer","authors":"Julia White MD","doi":"10.1053/j.sembd.2006.10.007","DOIUrl":"10.1053/j.sembd.2006.10.007","url":null,"abstract":"<div><p>Breast conservation therapy<span><span> is fully accepted as a recommended treatment instead of mastectomy for suitable early stage breast cancer patients. Long term results from the initial randomized trial comparing BCT to mastectomy have demonstrated comparable local control and equivalent survival. The diagnosis and treatment of breast cancer has evolved over the past 2 decades since the randomized trials were initiated. For example, there is now widespread </span>mammography screening, better understanding of breast cancer pathology, and emergence of numerous effective systemic therapy agents. This makes it timely to review the current methods for BCT. This review will focus on the radiation component of BCT, its impact on local cancer control, and how newer radiation technologies may help preserve local control while reducing toxicity and burden of care.</span></p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"9 1","pages":"Pages 30-38"},"PeriodicalIF":0.0,"publicationDate":"2006-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2006.10.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57938681","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":"As the Median Size of Invasive Breast Cancers at Time of Diagnosis Continues to Fall, How Does the Oncologist Guard Against Over-Treatment?","authors":"Peter M. Ravdin PhD, MD","doi":"10.1053/j.sembd.2006.10.003","DOIUrl":"10.1053/j.sembd.2006.10.003","url":null,"abstract":"<div><p>Because of mammographic screening, the most common presentation of breast cancer is now as Stage 1 disease. These patients have on average a low risk of recurrence and death due to their primary cancer of about 10% on average. Most of these patients will never relapse and, therefore, to treat all these patients is clearly less than ideal. Unfortunately, current clinical and pathologic information cannot reliably identify who is destined to relapse. For most of these patients, therefore, a decision needs to be made about whether and what type of adjuvant therapy should be given. For many of these low-risk patients, it is often not obvious what the balance is between the benefit of adjuvant therapy (which on average will be small) versus its risks and costs. There are various approaches to making these decisions, but present day guidelines are not entirely satisfactory, because although they are evidence based, they often lack quantitative information. This leaves the patient and her physician unable to reweigh the evidence for themselves, and this is not informed decision making. Decision tools are playing ever greater roles in medicine. Even more so than guidelines, they can give individualized estimates. Furthermore, they also can provide individualized quantitative information. Decision tools, like guidelines, have limitations in that they are only as strong as the data on which they are based, and it is important that they acknowledge areas of controversy and conflicted views about the interpretation of the data. Some of the issues involved in the use of decision tools are illustrated in a discussion of the tool Adjuvant!. These tools now are using classical clinical and pathologic parameters, but have the potential to incorporate parameters from the new multigene molecular tests.</p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"9 1","pages":"Pages 25-29"},"PeriodicalIF":0.0,"publicationDate":"2006-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2006.10.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57938183","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}
Jeff Seebach MD , Rachel E. Ellsworth PhD , Craig D. Shriver MD, FACS
{"title":"A Molecular Profiling of Breast Cancer","authors":"Jeff Seebach MD , Rachel E. Ellsworth PhD , Craig D. Shriver MD, FACS","doi":"10.1053/j.sembd.2006.10.005","DOIUrl":"10.1053/j.sembd.2006.10.005","url":null,"abstract":"<div><p><span><span>Despite tremendous advances in breast cancer characterization and therapy over the last 20 years, clinicians still have difficulty accurately predicting the prognosis for individual breast cancer patients. Patients with identical histologic tumor characteristics can have markedly different outcomes in terms of distant metastasis-free and overall survival. Microarray expression profiling is a novel method to further characterize breast cancer tumors at the gene expression level. Breast cancer subtypes have been described which display different clinical behavior. In addition, groups of genes, known as gene-signatures, have been identified which provide more accurate prognostic factors than current clinical and histologic features. Prospective, </span>randomized clinical trials have been conceived regarding two of these signatures (Onco</span><em>type</em>DX<sup>™</sup> and MammaPrint®), which are currently available for clinical use. Future clinical decisions may rely on expression profiling of breast tumors.</p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"9 1","pages":"Pages 19-24"},"PeriodicalIF":0.0,"publicationDate":"2006-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2006.10.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57938589","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":"Impact of ACRIN DMIST Results on the Technologist and Mammography Practice","authors":"R. Edward Hendrick PhD, FACR","doi":"10.1053/j.sembd.2006.08.004","DOIUrl":"10.1053/j.sembd.2006.08.004","url":null,"abstract":"<div><p>ACRIN DMIST was sponsored by the National Cancer Institute and enrolled a total of 49,528 asymptomatic women to compare the performance of digital and screen-film mammography for screening. The study used a paired design in which each woman received both a digital and screen-film mammography examination performed by the same technologist in randomized order. Mammograms were interpreted independently by two radiologists. All relevant follow-up information including cancer status was available for 42,760 of the enrolled women (86.3%). For the full study population with complete follow up, the diagnostic accuracy of digital and screen-film mammography was similar, as assessed by ROC curve areas. For the overlapping subgroups of women under age 50, pre- or peri-menopausal women, and women with heterogeneously dense or extremely dense breasts, digital was found to be superior to screen-film mammography with statistical significance. The details of these results and their implications for your mammography practice are discussed.</p></div>","PeriodicalId":87785,"journal":{"name":"Seminars in breast disease","volume":"8 4","pages":"Pages 178-184"},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sembd.2006.08.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57937914","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}