Image-guided Procedure Versus 2-year Follow-up for a BI-RADS 3 Probably Benign Lesion: A Cost Comparison Analysis.

Objective: Perform a comparison between the costs of image-guided breast procedures versus 2-year imaging follow-up for findings classified as BI-RADS assessment category 3-probably benign.

Methods: The national payment amount costs at non-facility locations were obtained from the Centers for Medicare and Medicaid Services physician fee schedule for breast imaging-related Current Procedural Terminology codes. Total costs were calculated and compared for management algorithms of 2-year imaging follow-up of a BI-RADS 3 lesion from 2018 through 2019 versus performing an image-guided procedure of the lesion in 2018 after the initial diagnostic imaging.

DeepCAT: Deep Computer-Aided Triage of Screening Mammography.

Although much deep learning research has focused on mammographic detection of breast cancer, relatively little attention has been paid to mammography triage for radiologist review. The purpose of this study was to develop and test DeepCAT, a deep learning system for mammography triage based on suspicion of cancer. Specifically, we evaluate DeepCAT's ability to provide two augmentations to radiologists: (1) discarding images unlikely to have cancer from radiologist review and (2) prioritization of images likely to contain cancer.

Benefits of digital breast tomosynthesis: A lesion-level analysis.

Objective: To compare outcome metrics of digital breast tomosynthesis (DBT) breast cancer screening with full-field digital mammogram (FFDM); specifically, to compare recall rates by the type of recalled finding, and to assess if screening with DBT versus FFDM changes biopsy recommendations and if the likelihood of malignancy varied by lesion type, if detected on DBT or FFDM screening mammogram.

Methods: The outcomes of 22,055 FFDM and DBT screening mammograms were retrospectively reviewed. The exams were performed at an academic institution between August 2015 and September 2016.

Outcomes of Foci on Breast MRI: Features Associated With Malignancy.

The objective of this study was to determine the outcomes of foci seen on breast MRI and to evaluate imaging features associated with malignancy. In this institutional review board-approved retrospective study, we reviewed 200 eligible foci in 179 patients that were assigned BI-RADS category of 3 or 4 from December 2004 to August 2018. Clinical and imaging features of all eligible foci were collected, and associations with malignant outcomes were evaluated.

A Global Perspective on Screening.

Breast cancer is emerging as a major global public health problem. Incidence and mortality continues to rise in low- and middle-income countries (LMICs). A significant and growing disparity exists between high-income countries and LMICs in the availability of screening services and associated preventable mortality.

Impact of Improved Screening Mammography Recall Lay Letter Readability on Patient Follow-Up.

Purpose: In the setting of abnormal results on screening mammography, the Mammography Quality Standards Act mandates that patients receive a mailed "recall" lay letter informing them to return for additional follow-up imaging. The language used in this letter should be "easily understood by a lay person." In February 2019, the authors' institution revised the language of its recall lay letter to the sixth grade reading level.

Analysis of Breast Cancer Patients with T1-2 Tumors and 1-3 Positive Lymph Nodes Treated with or without Postmastectomy Radiation Therapy.

The use of postmastectomy radiation therapy (PMRT) has been recommended for patients with 4 or more positive lymph nodes, however, its role in patients with 1-3 positive lymph nodes remains unclear. The purpose of this study is to evaluate oncological outcomes for breast cancer patients with T1-2 tumors and 1-3 positive lymph nodes after undergoing PMRT. We performed a single-institution retrospective investigation that evaluated the association between PMRT and outcomes in breast cancer patients with T1-2 tumors and 1-3 positive lymph nodes, who underwent mastectomy from 2004 to 2015.

Impact of Telephone Communication on Patient Adherence With Follow-Up Recommendations After an Abnormal Screening Mammogram.

Objective: The Mammography Quality Standards Act requires written communication to every patient after an abnormal screening mammogram. Starting in 2013, our institution began telephoning all patients with a Breast Imaging Reporting and Data System (BI-RADS) assessment 0 on the next business day to schedule their diagnostic follow-up. Our aim is to analyze the changes in adherence and time to follow-up of patients recalled from screening mammography after the implementation of telephone communication.

Towards CNN-Based Registration of Craniocaudal and Mediolateral Oblique 2-D X-ray Mammographic Images.

We investigate methodologies for the automated registration of pairs of 2-D X-ray mammographic images, taken from the two standard mammographic angles. We present two exploratory techniques, based on Convolutional Neural Networks, to examine their potential for co-registration of findings on the two standard mammographic views. To test algorithm performance, our analysis uses a synthetic, surrogate data set for performing controlled experiments, as well as real 2-D X-ray mammogram imagery.

Breast MRI BI-RADS 3: Impact of Patient-Level Factors on Compliance With Short-Term Follow-Up.

Purpose: A BI-RADS 3 assessment on breast MRI is given when a finding is estimated to have less than 2% chance of breast cancer. Patients in this category are typically recommended to return for a 6-month follow-up MRI. Compliance with this recommendation is low, and we aim to understand which factors are associated with compliance.

Multiparametric deep learning tissue signatures for a radiological biomarker of breast cancer: Preliminary results.

Purpose: Deep learning is emerging in radiology due to the increased computational capabilities available to reading rooms. These computational developments have the ability to mimic the radiologist and may allow for more accurate tissue characterization of normal and pathological lesion tissue to assist radiologists in defining different diseases. We introduce a novel tissue signature model based on tissue characteristics in breast tissue from multiparametric magnetic resonance imaging (mpMRI).

Improving State-Mandated Breast Density Notifications.

Purpose: Effective written communication directly affects health care outcomes. Since 2016, the complex language of state-mandated breast density notifications (BDNs) has been challenged, because it is perceived to be beyond the comprehension of most patients. The aim of this study was to assess whether a revised BDN written at a lower reading grade level improves understanding compared with the current state-mandated BDN.

Ultrasound for Breast Cancer Detection Globally: A Systematic Review and Meta-Analysis.

Purpose: Mammography is not always available or feasible. The purpose of this systematic review and meta-analysis is to assess the diagnostic performance of ultrasound as a primary tool for early detection of breast cancer.

Materials And Methods: For this systematic review and meta-analysis, we comprehensively searched PubMed and SCOPUS to identify articles from January 2000 to December 2018 that included data on the performance of ultrasound for detection of breast cancer.

DNA Methylation Markers for Breast Cancer Detection in the Developing World.

Purpose: An unmet need in low-resource countries is an automated breast cancer detection assay to prioritize women who should undergo core breast biopsy and pathologic review. Therefore, we sought to identify and validate a panel of methylated DNA markers to discriminate between cancer and benign breast lesions using cells obtained by fine-needle aspiration (FNA). Two case-control studies were conducted comparing cancer and benign breast tissue identified from clinical repositories in the United States, China, and South Africa for marker selection/training ( = 226) and testing ( = 246).

Improving Patient Comprehension of Screening Mammography Recall Lay Letters.

Purpose: In accordance with the Mammography Quality Standards Act, recall lay letters should be written using language that is "easily understood by a lay person." The authors hypothesized that the readability of their institution's current recall lay letter may contribute to the misinterpretation of intended time for patient return. Thus, the aim of this study was to evaluate the comprehension of the current recall lay letter statement.

Deep-Learning-Based Semantic Labeling for 2D Mammography and Comparison of Complexity for Machine Learning Tasks.

Machine learning has several potential uses in medical imaging for semantic labeling of images to improve radiologist workflow and to triage studies for review. The purpose of this study was to (1) develop deep convolutional neural networks (DCNNs) for automated classification of 2D mammography views, determination of breast laterality, and assessment and of breast tissue density; and (2) compare the performance of DCNNs on these tasks of varying complexity to each other. We obtained 3034 2D-mammographic images from the Digital Database for Screening Mammography, annotated with mammographic view, image laterality, and breast tissue density.

Review of axillary web syndrome: What the radiologist should know.

Axillary web syndrome is common after axillary surgery, frequently affecting breast cancer patients. In this condition, patients develop one or more linear bands of firm tissue, also known as "cords", in the axilla and arm, associated with pain and limited range of motion of the shoulder and arm. Radiologists may encounter this syndrome in patients referred for axillary or upper extremity ultrasound, and should be aware of the physical examination and ultrasound findings for accurate diagnosis.

Factors Impacting False Positive Recall in Screening Mammography.

Rationale And Objectives: Our objective was to identify factors impacting false positive recalls in screening mammography.

Materials And Methods: We retrospectively reviewed our screening mammography database from August 31, 2015 to September 30, 2016, including full field digital mammograms (FFDM) and digital breast tomosynthesis (DBT) mammograms. False positive (FP) exams were defined as Breast Imaging-Reporting and Data System (BI-RADS) 1 or 2 assessments at diagnostic imaging with 1 year cancer-free follow-up, Breast Imaging-Reporting and Data System 3 assessment at diagnostic imaging with 2 years cancer free follow-up, or biopsy with benign pathology.

A Pilot of Data-Driven Modeling to Assess Potential for Improved Efficiency in an Academic Breast-Imaging Center.

Patient satisfaction and department efficiency are central pillars in defining quality in medicine. Patient satisfaction is often linked to wait times. We describe a novel method to study workflow and simulate solutions to improve efficiency, thereby decreasing wait times and adding value.

Variability in Individual Radiologist BI-RADS 3 Usage at a Large Academic Center: What's the Cause and What Should We Do About It?

Rationale And Objectives: Although the breast imaging reporting and data system (BI-RADS) lists specific criteria for designating a lesion as BI-RADS category 3 (probably benign), there are no target benchmarks for BI-RADS 3 usage rates. This study investigates the variability of BI-RADS 3 rates among a group of academic breast imagers, with the goal of defining more precise utilization.

Materials And Methods: We retrospectively reviewed all diagnostic mammograms performed between July 1, 2013 and August 8, 2017 at our academic institution.

Digital breast tomosynthesis: Image acquisition principles and artifacts.

Digital breast tomosynthesis (DBT) is a new technology that is being used more frequently for both breast cancer screening and diagnostic purposes and its utilization is likely to continue to increase over time. The major benefit of tomosynthesis over 2D-mammography is that it allows radiologists to view breast tissue using a three-dimensional dataset and improves diagnostic accuracy by facilitating differentiation of potentially malignant lesions from overlap of normal tissue. In addition, image processing techniques allow reconstruction of two dimensional synthesized mammograms (SM) from DBT data, which eliminates the need for acquiring two dimensional full field digital mammography (FFDM) in addition to tomosynthesis and thereby reduces the radiation dose.