Diagnostic Mammography in Breast Imaging

Breast Imaging and the Symptomatic Patient: Enough with the “Diagnostic” Mammography

American Journal of Roentgenology ◽

10.2214/ajr.181.5.1811423 ◽

2003 ◽

Vol 181 (5) ◽

pp. 1423-1424 ◽

Cited By ~ 5

Author(s):

Daniel B. Kopans

Keyword(s):

Breast Imaging ◽

Symptomatic Patient ◽

Diagnostic Mammography

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Posterior breast cancer: Mammographic and ultrasonographic features

Vojnosanitetski pregled ◽

10.2298/vsp120726032j ◽

2013 ◽

Vol 70 (11) ◽

pp. 1034-1038

Author(s):

Ana Jankovic ◽

Mirjan Nadrljanski ◽

Vesna Plesinac-Karapandzic ◽

Nebojsa Ivanovic ◽

Zoran Radojicic ◽

...

Keyword(s):

Breast Cancer ◽

Breast Imaging ◽

Color Doppler ◽

Lobular Carcinoma ◽

Architectural Distortion ◽

Breast Cancers ◽

Significant Difference ◽

Diagnostic Mammography ◽

Anatomical Localization ◽

Mass Lesions

Background/Aim. Posterior breast cancers are located in the prepectoral region of the breast. Owing to this distinctive anatomical localization, physical examination and mammographic or ultrasonographic evaluation can be difficult. The purpose of the study was to assess possibilities of diagnostic mammography and breast ultrasonography in detection and differentiation of posterior breast cancers. Methods. The study included 40 women with palpable, histopathological confirmed posterior breast cancer. Mammographic and ultrasonographic features were defined according to Breast Imaging Reporting and Data System (BI-RADS) lexicon. Results. Based on standard two-view mammography 87.5%, of the cases were classified as BI-RADS 4 and 5 categories, while after additional mammographic views all the cases were defined as BIRADS 4 and 5 categories. Among 96 mammographic descriptors, the most frequent were: spiculated mass (24.0%), architectural distortion (16.7%), clustered microcalcifications (12.6%) and focal asymmetric density (12.6%). The differentiation of the spiculated mass was significantly associated with the possibility to visualize the lesion at two-view mammography (p = 0.009), without the association with lesion diameter (p = 0.083) or histopathological type (p = 0.055). Mammographic signs of invasive lobular carcinoma were significantly different from other histopathological types (architectural distortion, p = 0.003; focal asymmetric density, p = 0.019; association of four or five subtle signs of malignancy, p = 0.006). All cancers were detectable by ultrasonography. Mass lesions were found in 82.0% of the cases. Among 153 ultrasonographic descriptors, the most frequent were: irregular mass (15.7%), lobulated mass (7.2%), abnormal color Doppler signals (20.3%), posterior acoustic attenuation (18.3%). Ultrasonographic BI-RADS 4 and 5 categories were defined in 72.5% of the cases, without a significant difference among various histopathological types (p = 0.109). Conclusion. Standard two-view mammography followed by additional mammographic projections is an effective way to demonstrate the spiculated mass and to classify the prepectoral lesion as category BI-RADS 4 or 5. Additional ultrasonography can overcome the mimicry of invasive lobular breast carcinoma at mammography.

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Dedicated Cone-beam Breast Computed Tomography and Diagnostic Mammography: Comparison of Radiation Dose, Patient Comfort, And Qualitative Review of Imaging Findings in BI-RADS 4 and 5 Lesions

Journal of Clinical Imaging Science ◽

10.4103/2156-7514.93274 ◽

2012 ◽

Vol 2 ◽

pp. 7 ◽

Cited By ~ 33

Author(s):

Avice M. O’Connell ◽

Daniel Kawakyu-O’Connor

Keyword(s):

Computed Tomography ◽

Radiation Dose ◽

Breast Imaging ◽

Qualitative Evaluation ◽

Patient Comfort ◽

Cone Beam ◽

Breast Lesions ◽

Diagnostic Mammography ◽

High Degree ◽

Breast Computed Tomography

Objective: This pilot study was undertaken to compare radiation dose, relative visibility/conspicuity of biopsy-proven lesions, and relative patient comfort in diagnostic mammography and dedicated cone-beam breast computed tomography (CBBCT) in Breast Imaging-Reporting and Data System (BI-RADS)® 4 or 5 lesions. Materials and Methods: Thirty-six consecutive patients (37 breasts) with abnormal mammographic and/or ultrasound categorized as BI-RADS® 4 or 5 lesions were evaluated with CBBCT prior to biopsy. Administered radiation dose was calculated for each modality. Mammograms and CBBCT images were compared side-by-side and lesion visibility/conspicuity was qualitatively scored. Histopathology of lesions was reviewed. Patients were administered a survey for qualitative evaluation of comfort between the two modalities. Results: CBBCT dose was similar to or less than diagnostic mammography, with a mean dose of 9.4 mGy (±3.1 SD) for CBBCT vs. 16.9 mGy (±6.9 SD) for diagnostic mammography in a total of 37 imaged breasts (P<0.001). Thirty-three of 34 mammographic lesions were scored as equally or better visualized in CBBCT relative to diagnostic mammography. Characterization of high-risk lesions was excellent. Patients reported greater comfort in CBBCT imaging relative to mammography. Conclusion: Our experience of side-by-side comparison of CBBCT and diagnostic mammography in BI-RADS® 4 and 5 breast lesions demonstrated a high degree of correlation between the two modalities across a variety of lesion types. Owing to favorable radiation dose profile, excellent visualization of lesions, and qualitative benefits including improved patient comfort, excellent field-of-view, and more anatomical evaluation of lesion margins, CBBCT offers a promising modality for diagnostic evaluation of breast lesions.

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Leveling the Workload for Radiologists in Diagnostic Mammography: Application of Lean Principles and Heijunka

Journal of Breast Imaging ◽

10.1093/jbi/wbab090 ◽

2021 ◽

Author(s):

Amy L Conners ◽

Sean E Clark ◽

Kathleen R Brandt ◽

Katie N Hunt ◽

Linda M Chida ◽

...

Keyword(s):

Quality Improvement ◽

Process Improvement ◽

Breast Imaging ◽

Reading Room ◽

Complex Environments ◽

Lean Principles ◽

Diagnostic Mammography ◽

Improvement Methodologies ◽

Level Loading ◽

Practice Implementation

Abstract To facilitate the delivery of accurate and timely care to patients in complex environments, process improvement methodologies such as Lean can be very effective. Lean is a quality improvement methodology that seeks to add value for patients and employees by continuously improving processes and eliminating waste. At our institution, Lean principles were applied to improve efficiency and minimize waste in the diagnostic breast imaging reading room. This paper describes how we applied Lean principles, including plan-do-study-act testing, level-loading (heijunka), and visual management, to level the workload of the diagnostic radiologists in our practice. Implementation of these principles to improve the diagnostic workflow in breast imaging is described along with examples from our practice, including challenges and future opportunities.

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