Matthew M Miller, Shanna Mayorov, Ramapriya Ganti, Jonathan V Nguyen, Carrie M Rochman, Matthew Caley, Jessie Jahjah, Kathy Repich, James T Patrie, Roger T Anderson, Jennifer A Harvey, Timothy B Rooney
Objective: We investigated patient experience with screening contrast-enhanced mammography (CEM) to determine whether a general population of women with dense breasts would accept CEM in a screening setting.
Methods: In this institutional review board-approved prospective study, patients with heterogeneous and extremely dense breasts on their mammogram were invited to undergo screening CEM and complete pre-CEM and post-CEM surveys. On the pre-CEM survey, patients were asked about their attitudes regarding supplemental screening in general. On the post-CEM survey, patients were asked about their experience undergoing screening CEM, including causes and severity of any discomfort and whether they would consider undergoing screening CEM again in the future or recommend it to a friend.
Results: One hundred sixty-three women were surveyed before and after screening CEM. Most patients, 97.5% (159/163), reported minimal or no unpleasantness associated with undergoing screening CEM. In addition, 91.4% (149/163) said they would probably or very likely undergo screening CEM in the future if it cost the same as a traditional screening mammogram, and 95.1% (155/163) said they would probably or very likely recommend screening CEM to a friend. Patients in this study, who were all willing to undergo CEM, more frequently reported a family history of breast cancer than a comparison cohort of women with dense breasts (58.2% vs 47.1%, P = .027).
Conclusion: Patients from a general population of women with dense breasts reported a positive experience undergoing screening CEM, suggesting screening CEM might be well received by this patient population, particularly if the cost was comparable with traditional screening mammography.
目的我们调查了患者对造影剂增强乳腺 X 线照相术（CEM）筛查的体验，以确定乳房致密的普通女性是否会接受 CEM 筛查：在这项经机构审查委员会批准的前瞻性研究中，乳房X光检查中乳房密度不均匀和极度致密的患者被邀请接受CEM筛查，并完成CEM前和CEM后调查。在 CEM 前的调查中，患者被问及他们对补充筛查的总体态度。在 CEM 后调查中，患者被问及她们接受 CEM 筛查的经历，包括任何不适的原因和严重程度，以及她们将来是否会考虑再次接受 CEM 筛查或向朋友推荐：163 名妇女在接受 CEM 筛查前后接受了调查。大多数患者（97.5%，159/163）表示，接受 CEM 筛查带来的不适感很小或没有。此外，91.4%（149/163）的患者表示，如果CEM筛查的费用与传统乳腺X光检查相同，她们将来可能或很可能会接受CEM筛查；95.1%（155/163）的患者表示，她们可能或很可能会向朋友推荐CEM筛查。本研究中的患者都愿意接受 CEM 筛查，她们报告有乳腺癌家族史的比例高于乳房致密的女性对比队列（58.2% vs 47.1%，P = .027）：结论：乳房致密的普通女性患者在接受CEM筛查时表现积极，这表明CEM筛查可能会受到这类患者的欢迎，尤其是在费用与传统乳房X光筛查相当的情况下。
{"title":"Patient Experience of Women With Dense Breasts Undergoing Screening Contrast-Enhanced Mammography.","authors":"Matthew M Miller, Shanna Mayorov, Ramapriya Ganti, Jonathan V Nguyen, Carrie M Rochman, Matthew Caley, Jessie Jahjah, Kathy Repich, James T Patrie, Roger T Anderson, Jennifer A Harvey, Timothy B Rooney","doi":"10.1093/jbi/wbae012","DOIUrl":"10.1093/jbi/wbae012","url":null,"abstract":"<p><strong>Objective: </strong>We investigated patient experience with screening contrast-enhanced mammography (CEM) to determine whether a general population of women with dense breasts would accept CEM in a screening setting.</p><p><strong>Methods: </strong>In this institutional review board-approved prospective study, patients with heterogeneous and extremely dense breasts on their mammogram were invited to undergo screening CEM and complete pre-CEM and post-CEM surveys. On the pre-CEM survey, patients were asked about their attitudes regarding supplemental screening in general. On the post-CEM survey, patients were asked about their experience undergoing screening CEM, including causes and severity of any discomfort and whether they would consider undergoing screening CEM again in the future or recommend it to a friend.</p><p><strong>Results: </strong>One hundred sixty-three women were surveyed before and after screening CEM. Most patients, 97.5% (159/163), reported minimal or no unpleasantness associated with undergoing screening CEM. In addition, 91.4% (149/163) said they would probably or very likely undergo screening CEM in the future if it cost the same as a traditional screening mammogram, and 95.1% (155/163) said they would probably or very likely recommend screening CEM to a friend. Patients in this study, who were all willing to undergo CEM, more frequently reported a family history of breast cancer than a comparison cohort of women with dense breasts (58.2% vs 47.1%, P = .027).</p><p><strong>Conclusion: </strong>Patients from a general population of women with dense breasts reported a positive experience undergoing screening CEM, suggesting screening CEM might be well received by this patient population, particularly if the cost was comparable with traditional screening mammography.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307239","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":"Ectopic Abdominal Breast Tissue.","authors":"Alexia R Tatem, Amie Y Lee","doi":"10.1093/jbi/wbad079","DOIUrl":"https://doi.org/10.1093/jbi/wbad079","url":null,"abstract":"","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477144","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":"Unknown Case: Palpable Mass in the Axilla.","authors":"Nafisa Reya, Mindy Yang","doi":"10.1093/jbi/wbad081","DOIUrl":"10.1093/jbi/wbad081","url":null,"abstract":"","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050666","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}
Anthony H Bui, Gretchen J Smith, Sara W Dyrstad, Kathryn A Robinson, Cheryl R Herman, Nicci Owusu-Brackett, Amy M Fowler
Breast pain is extremely common, occurring in 70% to 80% of women. Most cases of breast pain are from physiologic or benign causes, and patients should be reassured and offered treatment strategies to alleviate symptoms, often without diagnostic imaging. A complete clinical history and physical examination is key for distinguishing intrinsic breast pain from extramammary pain. Breast pain without other suspicious symptoms and with a negative history and physical examination result is rarely associated with malignancy, although it is a common reason for women to undergo diagnostic imaging. When breast imaging is indicated, guidelines according to the American College of Radiology Appropriateness Criteria should be followed as to whether mammography, US, or both are recommended. This review article summarizes the initial clinical evaluation of breast pain and evidence-based guidelines for imaging. Additionally, the article reviews cyclical and noncyclical breast pain and provides an image-rich discussion of the imaging presentation and management of benign and malignant breast pain etiologies.
乳房疼痛极为常见，70% 至 80% 的女性都会出现乳房疼痛。大多数乳房疼痛是由生理性或良性原因引起的，患者应得到安抚，并向其提供缓解症状的治疗策略，通常无需进行影像学诊断。完整的临床病史和体格检查是区分乳房内在疼痛和乳房外疼痛的关键。没有其他可疑症状、病史和体格检查结果均为阴性的乳房疼痛很少与恶性肿瘤有关，但这也是妇女接受影像学诊断的常见原因。当需要进行乳房造影检查时，应根据美国放射学会的适当性标准来决定是否建议进行乳房 X 线照相术、乳房 X 线造影术或同时进行这两种检查。这篇综述文章总结了乳房疼痛的初步临床评估和影像学循证指南。此外，文章还回顾了周期性和非周期性乳房疼痛，并对良性和恶性乳房疼痛病因的影像表现和处理进行了丰富的讨论。
{"title":"An Image-Rich Educational Review of Breast Pain.","authors":"Anthony H Bui, Gretchen J Smith, Sara W Dyrstad, Kathryn A Robinson, Cheryl R Herman, Nicci Owusu-Brackett, Amy M Fowler","doi":"10.1093/jbi/wbae001","DOIUrl":"10.1093/jbi/wbae001","url":null,"abstract":"<p><p>Breast pain is extremely common, occurring in 70% to 80% of women. Most cases of breast pain are from physiologic or benign causes, and patients should be reassured and offered treatment strategies to alleviate symptoms, often without diagnostic imaging. A complete clinical history and physical examination is key for distinguishing intrinsic breast pain from extramammary pain. Breast pain without other suspicious symptoms and with a negative history and physical examination result is rarely associated with malignancy, although it is a common reason for women to undergo diagnostic imaging. When breast imaging is indicated, guidelines according to the American College of Radiology Appropriateness Criteria should be followed as to whether mammography, US, or both are recommended. This review article summarizes the initial clinical evaluation of breast pain and evidence-based guidelines for imaging. Additionally, the article reviews cyclical and noncyclical breast pain and provides an image-rich discussion of the imaging presentation and management of benign and malignant breast pain etiologies.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11129617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
With the growing utilization and expanding role of breast MRI, breast imaging radiologists may encounter an increasing number of incidental findings beyond the breast and axilla. Breast MRI encompasses a large area of anatomic coverage extending from the lower neck to the upper abdomen. While most incidental findings on breast MRI are benign, identifying metastatic disease can have a substantial impact on staging, prognosis, and treatment. Breast imaging radiologists should be familiar with common sites, MRI features, and breast cancer subtypes associated with metastatic disease to assist in differentiating malignant from benign findings. Furthermore, detection of malignancies of nonbreast origin as well as nonmalignant, but clinically relevant, incidental findings can significantly impact clinical management and patient outcomes. Breast imaging radiologists should consistently follow a comprehensive search pattern and employ techniques to improve the detection of these important incidental findings.
{"title":"Forget Me Not: Incidental Findings on Breast MRI.","authors":"Maggie Chung, Lauren Ton, Amie Y Lee","doi":"10.1093/jbi/wbae023","DOIUrl":"https://doi.org/10.1093/jbi/wbae023","url":null,"abstract":"With the growing utilization and expanding role of breast MRI, breast imaging radiologists may encounter an increasing number of incidental findings beyond the breast and axilla. Breast MRI encompasses a large area of anatomic coverage extending from the lower neck to the upper abdomen. While most incidental findings on breast MRI are benign, identifying metastatic disease can have a substantial impact on staging, prognosis, and treatment. Breast imaging radiologists should be familiar with common sites, MRI features, and breast cancer subtypes associated with metastatic disease to assist in differentiating malignant from benign findings. Furthermore, detection of malignancies of nonbreast origin as well as nonmalignant, but clinically relevant, incidental findings can significantly impact clinical management and patient outcomes. Breast imaging radiologists should consistently follow a comprehensive search pattern and employ techniques to improve the detection of these important incidental findings.","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140964055","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":"Left Ventricular Assist Device Artifact on Digital Breast Tomosynthesis","authors":"Ryan Kim, Jeffrey Nelson","doi":"10.1093/jbi/wbad087","DOIUrl":"https://doi.org/10.1093/jbi/wbad087","url":null,"abstract":"","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140975945","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":"Severe Adverse Event Related to Holding Antithrombotic Therapy Before Breast Biopsy.","authors":"Heather Garrett, Debbie Bennett","doi":"10.1093/jbi/wbad090","DOIUrl":"https://doi.org/10.1093/jbi/wbad090","url":null,"abstract":"","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477139","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}
Allyson L Chesebro, Nooshin Abbasi, Ronilda C. Lacson, S. Chikarmane, Andro Licaros, C. Giess
OBJECTIVE To evaluate the association of mammographic, radiologist, and patient factors on BI-RADS 3 assessment at diagnostic mammography in patients recalled from screening mammography. METHODS This Institutional Review Board-approved retrospective study of consecutive unique diagnostic mammography examinations in asymptomatic patients recalled from screening mammography March 5, 2014, to December 31, 2019, was conducted in a single large United States health care institution. Mammographic features (mass, calcification, distortion, asymmetry), breast density, prior examination, and BI-RADS assessment were extracted from reports by natural language processing. Patient age, race, and ethnicity were extracted from the electronic health record. Radiologist years in practice, recall rate, and number of interpreted diagnostic mammograms were calculated. A mixed effect logistic regression model evaluated factors associated with likelihood of BI-RADS 3 compared with other BI-RADS assessments. RESULTS A total of 12 080 diagnostic mammography examinations were performed during the study period, yielding 2010 (16.6%) BI-RADS 3 and 10 070 (83.4%) other BI-RADS assessments. Asymmetry (odds ratio [OR] = 6.49, P <.001) and calcification (OR = 5.59, P <.001) were associated with increased likelihood of BI-RADS 3 assessment; distortion (OR = 0.20, P <.001), dense breast parenchyma (OR = 0.82, P <.001), prior examination (OR = 0.63, P = .01), and increasing patient age (OR = 0.99, P <.001) were associated with decreased likelihood. Mass, patient race or ethnicity, and radiologist factors were not significantly associated with BI-RADS 3 assessment. Malignancy rate for BI-RADS 3 lesions was 1.6%. CONCLUSION Asymmetry and calcifications had an increased likelihood of BI-RADS 3 assessment at diagnostic evaluation with low likelihood of malignancy, while radiologist features had no association.
{"title":"The Impact of Mammographic, Radiologist, and Patient Factors on the Likelihood of Probably Benign (BI-RADS 3) Assessment at Diagnostic Mammography.","authors":"Allyson L Chesebro, Nooshin Abbasi, Ronilda C. Lacson, S. Chikarmane, Andro Licaros, C. Giess","doi":"10.1093/jbi/wbae014","DOIUrl":"https://doi.org/10.1093/jbi/wbae014","url":null,"abstract":"OBJECTIVE\u0000To evaluate the association of mammographic, radiologist, and patient factors on BI-RADS 3 assessment at diagnostic mammography in patients recalled from screening mammography.\u0000\u0000\u0000METHODS\u0000This Institutional Review Board-approved retrospective study of consecutive unique diagnostic mammography examinations in asymptomatic patients recalled from screening mammography March 5, 2014, to December 31, 2019, was conducted in a single large United States health care institution. Mammographic features (mass, calcification, distortion, asymmetry), breast density, prior examination, and BI-RADS assessment were extracted from reports by natural language processing. Patient age, race, and ethnicity were extracted from the electronic health record. Radiologist years in practice, recall rate, and number of interpreted diagnostic mammograms were calculated. A mixed effect logistic regression model evaluated factors associated with likelihood of BI-RADS 3 compared with other BI-RADS assessments.\u0000\u0000\u0000RESULTS\u0000A total of 12 080 diagnostic mammography examinations were performed during the study period, yielding 2010 (16.6%) BI-RADS 3 and 10 070 (83.4%) other BI-RADS assessments. Asymmetry (odds ratio [OR] = 6.49, P <.001) and calcification (OR = 5.59, P <.001) were associated with increased likelihood of BI-RADS 3 assessment; distortion (OR = 0.20, P <.001), dense breast parenchyma (OR = 0.82, P <.001), prior examination (OR = 0.63, P = .01), and increasing patient age (OR = 0.99, P <.001) were associated with decreased likelihood. Mass, patient race or ethnicity, and radiologist factors were not significantly associated with BI-RADS 3 assessment. Malignancy rate for BI-RADS 3 lesions was 1.6%.\u0000\u0000\u0000CONCLUSION\u0000Asymmetry and calcifications had an increased likelihood of BI-RADS 3 assessment at diagnostic evaluation with low likelihood of malignancy, while radiologist features had no association.","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140660627","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":"Axillary Lymph Node With High Density and Echogenic Foci due to Tattoo Pigment Deposition","authors":"Elizabeth G. Lane, Katerina Dodelzon","doi":"10.1093/jbi/wbad084","DOIUrl":"https://doi.org/10.1093/jbi/wbad084","url":null,"abstract":"","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140668986","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":"Axillary Lymph Nodal Calcifications due to Systemic Amyloidosis","authors":"Luis Monterroso, H. Ojeda-Fournier","doi":"10.1093/jbi/wbad085","DOIUrl":"https://doi.org/10.1093/jbi/wbad085","url":null,"abstract":"","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140681762","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}
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