Mammography

As usual, Dr. Kopans' editorial in support of mammography screening is persuasive and compelling; it is also misleading, largely because of the information he withholds.1

As Diagnostic Imaging previously mentioned, most women at high risk for breast cancer come in for their breast MRI. However, claustrophobia and reluctant patients still exist. Below breast imagers offer their tips.

Breast cancer is one of the leading causes of cancer death among women. The risk of breast cancer typically increases with age in most countries.

Recent news coverage makes it seem as if women at high risk for breast cancer are refusing breast MRI screening left and right. That’s simply not the case, according to several experts.

New offerings shown at RSNA 2009 by the makers of digital mammography equipment reflected a new reality in the U.S. market, one based on cost constraints and diminishing demand. Vendors emphasized low-cost solutions that guard against obsolescence at the expense of premium ones, a change spurred by the continuing recession in the U.S. and an installed base increasingly saturated with high-end full-field digital mammography systems.

The controversy surrounding mammography screening guidelines announced in November by the influential U.S. Preventive Health Services Task Force has continued to swirl in the nation’s capital.

This month's cover story marks a departure for us. Normally, we would feature a clinical review article, or a look at clinical or economic trends written by the magazine's staff.

Mammography screening is one of the major medical successes of the past several decades, yet this fact seems unable to break free of the doubts promulgated by such articles as Dr. Leonard Berlin's.

Breast cancer detection rates increase substantially when women at high risk and those with dense breasts undergo mammography and ultrasound annually, according to a study presented Wednesday at the 2009 RSNA meeting. MRI is an even more effective technique when used with mammography, but only for women who are at high risk for the condition.

RSNA newbie Real-Time Tomography launched at this year’s meeting a new image processing and enhancement software library for digital mammography. But the product, dubbed Adara, will not be sold to providers, at least not directly. Real-Time Tomography came to Chicago with hopes of attracting original equipment manufacturers to its library.

RSNA newbie Real-Time Tomography launched at this year’s meeting a new image processing and enhancement software library for digital mammography.

Targeted breast ultrasound is less invasive and expensive than biopsy, as well as reduces anxiety over breast cancer screening.

Using sophisticated mapping technology, census data, and state cancer registry statistics, researchers from Georgia established a link between the presence of Mammography Quality Standards Act-certified mammography centers and lower death rates from breast cancer.

MRI is the best method to assess breast cancer tumor size prior to surgery and after chemotherapy, according to findings from the American College of Radiology Imaging Network trial 6657. Size on mammography does not correlate with true residual disease in patients treated with neoadjuvant chemotherapy and thus MRI is the best modality, the researchers said.

Radiation from mammography screenings may increase the chances of developing breast cancer for women at high risk, according to findings presented Tuesday at the 2009 RSNA meeting.

Full-field digital mammography significantly increases the cancer detection rate for women younger than 50 years, according to a study presented Monday afternoon at the RSNA meeting.

Digital mammography plus MRI is the most clinically effective strategy for screening women carrying a genetic mutation known to increase the risk for breast cancer. However, unless the cost of breast MRI decreases substantially, the modality doesn’t translate as cost-effective, according to a study presented on Tuesday at the RSNA 2009 meeting.

Developing a structured and rigorous peer-review quality assurance process that involves ongoing case presentations, open discussion, and consensus opinions can help to decrease perception errors and improve the interpretive skills of breast imagers, according to radiologists at Beth Israel Deaconess Medical Center in Boston.

Radiologists will often not biopsy small lesions because they assume the lesions are benign. But the decision to do so could mean missing malignant cases, according to a scientific session presented Sunday at the RSNA 2009 meeting.

Fujifilm Medical Systems USA will unveil new products in computed and digital radiography, as well as digital mammography and information technology at the RSNA 2009 meeting.

The Barbara Ann Karmanos Cancer Institute has launched a new company to build and market a breast cancer screening device invented at the institute, one that uses ultrasound and computer algorithms to assess patients.

Powerful political sources are lining up with radiologists and mammographers against guidelines from a federal panel that scrap longstanding policies for the timing of screening mammography. Even the U.S. Department of Health and Human Services is distancing itself from its panel’s recommendations in the wake of criticism from many women’s health advocates and breast cancer survivors.

The U.S. Preventive Services Task Force has issued a recommendation against routine breast cancer screening for women ages 40 to 49 and suggests the screening interval should be changed from every year to every two years beginning at age 50. The new recommendations will result in “many needless deaths,” said a joint statement from the American College of Radiology and the Society of Breast Imaging

African American women take longer to come in for follow-up care after a suspicious breast abnormality is found, according to a study from the University of South Carolina. The problem may have more to do with economics than race, according to a physician with extensive clinical experience with this unique patient population.

X-ray imaging has provided important diagnostic information for clinical applications for almost a century.

The largest population-based study to date comparing filmscreen mammography and full-field digital mammography has found the digital approach is superior for visualizing microcalcifications deemed crucial to diagnosing ductal carcinoma in situ.

Computer-aided detection software developed especially for coronary CT angiography could boost imagers’ ability to detect clinically relevant stenosis in patients at low to moderate risk of coronary artery disease, according to researchers at the Medical University of South Carolina.

Specialties outside of radiology could benefit from unified databases and iPhone applications.

A long-term study of breast imaging in Massachusetts has confirmed what mammographers have argued for years: older adult women who do not receive regular screening mammography are far more likely to die of breast cancer than women who routinely undergo the procedure.

Radiologists and surgeons doubt the potential value of federal legislation aimed at improved breast cancer awareness among young women and more extensive disease management for patients who undergo breast surgery.