Breast Imaging

Breast imaging includes imaging modalities used for breast cancer screenings and planning therapy once cancer is detected. Mammography is the primary modality used. Mammogram technology is moving from 2D full-field digital mammography (FFDM) to breast tomosynthesis, or 3D mammography, which helps reduce false positive exams by allowing radiologists to look through the layers of tissue. Overlapping areas of dense breast tissue on 2D mammograms appear similar to cancers and 3D tomo helps determine if suspect areas are cancer or not. About 50% of women have dense breast tissue, which appears white on mammograms, the same as cancers, making diagnosis difficult. Radiologists use the Breast Imaging Reporting and Data System (BI-RADS) scoring system to define the density of breast tissue. Many states now require patients to be notified if they have dense breasts so they understand their mammograms might be suboptimal and they should use supplemental imaging that can see through the dense areas. This includes tomosythesis, breast ultrasound, automated breast ultrasound (ABUS), breast MRI, contrast enhanced mammography and nuclear imaging, including positron emission mammography (PEM).

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Providers are requesting fewer preoperative MRIs for breast cancer patients

Female surgeons, in particular, are abiding by evidence-based guidelines, but a more selective approach is still needed among doctors.

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Ditching paper for e-worklist translates to ‘substantially’ shorter wait times for breast imaging patients

Brigham and Women's recently started using an electronic health record-embedded tool, resulting in many improvements for preoperative breast localization procedures.

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Breast radiologists’ opinions diverge on how to structure resident education, rotations

Imaging experts said they were "surprised" at the lack of consensus regarding how to manage first rotations during a 12-week program.

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Radiology advocates update breast cancer screening guidance to reflect higher risk for minority women

The American College of Radiology and Society of Breast Imaging noted women of color are 72% more likely to be diagnosed with the disease before they turn 50 compared to non-Hispanic white women.

Radiologists’ public service message underscores need to educate patients on COVID-19 vaccine side effects

Physicians called on imaging societies, clinicians and news media to spread awareness about vaccine-related swollen lymph nodes.

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Fast breast MRI ready for clinical use following shorter read times, accurate cancer detection

Abbreviated MRI protocols not only shorten exam times but may significantly reduce costs and improve breast cancer screening overall.

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All radiologists likely to encounter COVID-19 vaccine side effects in coming months, experts say

Massachusetts General Hospital rads outlined steps providers can take to limit unnecessary follow-up care in these situations, sharing their guidance in JACR.

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Here’s how radiologists should manage COVID-19 vaccine side effects spotted on breast MRI exams

Doctors have increasingly been seeing breast exams with swollen lymph nodes imitating cancer in patients who have received a vaccine, prompting Penn Medicine providers to offer up guidance.

Around the web

CMS has more than doubled the CCTA payment rate from $175 to $357.13. The move, expected to have a significant impact on the utilization of cardiac CT, received immediate praise from imaging specialists.

The newly cleared offering, AutoChamber, was designed with opportunistic screening in mind. It can evaluate many different kinds of CT images, including those originally gathered to screen patients for lung cancer. 

AI-enabled coronary plaque assessments deliver significant value, according to late-breaking data presented at TCT. These AI platforms have gained considerable momentum in recent months, receiving expanded Medicare coverage in addition to a new Category I CPT code.

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