Outcome of Architectural Distortion Detected Only at Breast Tomosynthesis versus 2D Mammography.

Purpose To compare the outcome of architectural distortion (AD) without associated mass only on digital breast tomosynthesis (DBT) with AD seen at two-dimensional (2D) mammography and to evaluate if the incidence of malignancy is influenced by the presence of a correlate at ultrasonography (US). Materials and Methods This retrospective study had institutional review board approval and was HIPAA compliant. All consecutive cases in which patients with AD were ultimately assigned Breast Imaging Reporting and Data System (BI-RADS) 4 or 5 categories from 2009 to 2016 were reviewed by three readers for visibility (2D vs DBT).

Comparison Between Digital and Synthetic 2D Mammograms in Breast Density Interpretation.

Objective: The purpose of this study was to compare assessments of breast density on synthetic 2D images as compared with digital 2D mammograms.

Materials And Methods: This retrospective study included consecutive women undergoing screening with digital 2D mammography and tomosynthesis during May 2015 with a negative or benign outcome. In separate reading sessions, three radiologists with 5-25 years of clinical experience and 1 year of experience with synthetic 2D mammography read digital 2D and synthetic 2D images and assigned breast density categories according to the 5th edition of BI-RADS.

Extranodal Lymphoma of the Breast.

Extranodal lymphoma represents fewer than 0.5% of all breast malignancies. Secondary involvement of the breast with lymphoma is more common than primary breast lymphoma.

3D-MR Ductography and Contrast-Enhanced MR Mammography in Patients with Suspicious Nipple Discharge; a Feasibility Study.

We evaluated contrast-enhanced magnetic resonance (ce-MR) imaging and an indirect MR galactogram (MRG) sequence against conventional galactography (CG) in women with suspicious nipple discharge who underwent histologic diagnosis. This study was Institutional Review Board approved and HIPAA compliant. Women with suspicious nipple discharge recommended for CG were recruited for our study.

A milestone-based approach to breast imaging instruction for residents.

Residency is historically an apprenticeship, learning through observation and instruction with varying degrees of structure. Since July 2013, the Next Accreditation System (NAS) of the ACGME has required the use of progressive milestones for each radiology residency rotation. The authors describe how a breast imaging curriculum can be structured to comply with the NAS.

The next accreditation system in radiology: a report from the APDR residency structure committee.

In a move to emphasize the educational outcomes of training programs, the ACGME has created the Next Accreditation System (NAS). The stated goals of NAS include aiding the ACGME in the accreditation of programs based on educational outcome measures, decreasing program burdens associated with the conventional process-based approach to ACGME accreditation, allowing good programs to innovate while enabling struggling programs to steadily improve, and providing public accountability for outcomes. Diagnostic radiology is among the first group of specialties to undergo NAS implementation and began operating under the NAS in July 2013.

Interactive case review of radiologic and pathologic findings from breast biopsy: are they concordant? How do I manage the results?

The number of imaging-guided percutaneous breast biopsies performed has steadily increased as imaging techniques have improved. Percutaneous biopsy is becoming more commonplace and supplanting excisional biopsy as the preferred diagnostic tool. The radiologist's role in caring for patients who undergo breast biopsy extends beyond imaging to identifying lesions for biopsy and then performing the procedure.

Incidental pleural effusions detected on screening breast MRI.

Objective: Pleural effusions are a common complication of malignancy that must be differentiated from physiologic effusions identified on breast MRI. This study aimed to determine the incidence and reference range of physiologic pleural effusions observed in healthy women undergoing screening breast MRI.

Materials And Methods: A retrospective analysis of 200 consecutive women who underwent screening breast MRI between December 2007 and December 2008 was performed.

Rim-enhancing breast masses with smooth or spiculated margins on magnetic resonance imaging: histopathology and clinical significance.

Rim enhancement is defined as enhancement that is more pronounced at the periphery of a mass. It can have varying appearances, ranging from a thin pattern to one that is thicker. This internal enhancement characteristic is an established characteristic of malignant lesions.

The new radiology residency fourth year under the new curriculum: a survey of current residents' thoughts and suggestions about its design and purpose.

Rationale And Objectives: The ABR announced changes to the board examinations for the resident class entering in 2010. These changes can allow the fourth year to be focused on subspecialization. During the restructuring process at the authors' institution, residents were queried about fourth-year design.

Short-term follow-up of palpable breast lesions with benign imaging features: evaluation of 375 lesions in 320 women.

Objective: The purpose of this study was to evaluate the feasibility of short-term follow-up of palpable masses that have benign imaging features.

Materials And Methods: The cases of all women with round, oval, or lobular palpable masses with circumscribed margins and homogeneous ultrasound echotexture for which short-term follow-up was recommended from July 1997 through December 2003 were retrospectively identified. Evaluation was by ultrasound and/or mammography and focused clinical examination.

Radiologist/Educator knowledge of the audience response system and limitations to its use.

Rationale And Objectives: Audience response systems (ARS) have been proven to increase residents' retention in the short and long terms. The purpose of this study was to determine what teaching faculty members know about the ARS at one institution, what the obstacles are to its use, and ways to increase its use.

Materials And Methods: An anonymous and voluntary survey was sent to teaching faculty members.

Nipple-areolar complex: normal anatomy and benign and malignant processes.

The nipple-areolar complex may be affected by many normal variations in embryologic development and breast maturation as well as by abnormal processes of a benign or malignant nature. Benign processes that may affect the nipple-areolar complex include eczema, duct ectasia, periductal mastitis, adenomas, papillomas, leiomyomas, and abscesses; malignant processes include Paget disease, lymphoma, and invasive and noninvasive breast cancers. Radiologists should be aware of the best methods for evaluating each of these entities: Many disorders of the nipple-areolar complex are unique or differ in important ways from those that occur elsewhere in the breast, and they require a diagnostically specific imaging evaluation.

Finding early invasive breast cancers: a practical approach.

Detection of early invasive breast cancer is important, as patient survival is high when the cancer is 2 cm or smaller. Invasive breast cancers typically manifest mammographically as focal asymmetries or masses. Strategies for detecting focal asymmetries and masses on screening mammograms include side-by-side comparison, looking for parenchymal contour deformity, close inspection of the retromammary fat, identifying the presence of associated findings, and comparison with prior mammograms.

Breast MR imaging artifacts: how to recognize and fix them.

Patient and technical factors may lead to unwanted artifacts at breast magnetic resonance (MR) imaging. Use of a properly functioning high-field-strength MR imaging system, a dedicated bilateral breast coil, and an optimal imaging protocol provides a solid framework for performing high-quality breast MR imaging. Problems related to breast positioning, selection of imaging volume, and phase-encoding direction can be overcome by training and providing feedback to MR imaging technologists.

Breaking bad news: a primer for radiologists in breast imaging.

The task of breaking bad news, whether news of need for biopsy or a new breast cancer diagnosis, is increasingly performed by breast imaging radiologists. Most radiologists have little exposure to didactic teaching or modeling for learning methods of breaking bad news. Understanding barriers for communicating bad news and general improvements in communication, such as avoiding jargon and active listening, are initial steps in learning this important task.

Accuracy of assigned BI-RADS breast density category definitions.

Rationale And Objectives: Quantitative criteria for the Breast Imaging Reporting and Data System (BI-RADS) mammographic density categories have recently been defined as <25% dense for almost entirely fatty, 25%-50% dense for scattered fibroglandular densities, 51%-75% for heterogeneously dense, and >75% dense for the extremely dense category. The purpose of this study is to compare the range of percent mammographic densities with radiologist-assigned BI-RADS mammographic density categories and compare with the recently issued definitions.

Materials And Methods: In this study, 200 consecutive negative analog screening mammograms were assigned BI-RADS mammographic density categories independently by three radiologists blinded to the other readers' density assignment.