Access to Breast Cancer Screening: Disparities and Determinants- Expert Panel Narrative Review.

While breast cancer screening reduces mortality, disparities in access continue to limit equitable care. Medically underserved groups-including American Indian or Alaska Native, Black, Hispanic, disabled, and LGBTQ+ individuals-face significant barriers in accessing screening mammography services. This AJR Expert Panel Narrative Review leverages the National Institute on Minority Health and Health Disparities Research Framework to analyze persistent inequities in screening, focusing on race, ethnicity, socioeconomic status, disabilities, health insurance, and geography.

ACR Appropriateness Criteria® Female Breast Cancer Screening: 2023 Update.

Early detection of breast cancer from regular screening substantially reduces breast cancer mortality and morbidity. Multiple different imaging modalities may be used to screen for breast cancer. Screening recommendations differ based on an individual's risk of developing breast cancer.

Facilitating Culturally Competent Breast Imaging Care in South Asian Patients.

South Asians are a rapidly growing subset of the Asian population in the United States. They comprise people from multiple countries with diverse beliefs, languages, and cultural identities and values. The incidence of breast cancer is rising in South Asian women in the United States, with earlier onset and predilection for HER2-enriched tumors.

A Needs Assessment for Inclusion, Diversity, and Equity: Survey Results of the Society of Breast Imaging.

Objective: To assess and understand the inclusion, diversity, and equity (IDE) needs of the Society of Breast Imaging (SBI) membership to guide development of a strategic plan and goals for the Inclusion, Diversity, Equity Alliance (IDEA) of SBI.

Methods: A 23-question survey developed by IDEA was distributed electronically to all SBI members in November 2020 to assess and understand the society's IDE needs. Descriptive statistics were used to summarize the responses.

Cultural Competence in the Care of LGBTQ+ Patients: A Primer for Breast/Chest Centers.

The number of individuals identifying as lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ+) has doubled over the past 10 years, and this figure continues to rise. The LGBTQ+ community is diverse, encompassing a vast array of differences in gender identity and sexual orientation. Additionally, it is inclusive of people from all races, ethnicities, religions, and socioeconomic backgrounds.

Raising Cultural Awareness and Addressing Barriers to Breast Imaging Care for Black Women.

Health care disparities, which are differences in the attainment of full health potential among population groups, have been documented across medical conditions, clinical settings, and diagnostic and treatment modalities. Deeply rooted health care disparities due to many factors have affected how Black women (BW) view medical care including screening mammography. This article explores health care disparities around breast cancer in BW and how patient distrust, provider biases, race, and social determinants of health continue to have negative effects on breast cancer outcomes in BW, despite medical advances in breast cancer detection and management.

Imaging Preferences in Women With a History of Breast Cancer Receiving Contrast-Enhanced Mammography.

Objective: There is interest in contrast-enhanced mammography (CEM) to screen breast cancer survivors, yet it is unclear whether they would accept CEM as their annual exam. The purpose of this study was to understand patient preferences to guide CEM implementation for screening.

Methods: Consecutive women with breast cancer history who had CEM as their annual mammogram from July 2020 to August 2021 at a single academic institution completed an 18-question survey regarding prior contrast imaging, CEM experience, and comparison to other breast imaging exams.

Breast Imaging Fellowship Training in the United States: A National Survey of Fellowship Program Directors.

Objective: To provide an updated characterization of breast imaging fellowship programs in the United States to identify opportunities for improvement and standardization.

Methods: An anonymous survey was e-mailed to program directors of breast imaging fellowship programs listed on the Society of Breast Imaging website. The survey was open from April 23, 2021, through May 27, 2021.

ACR Appropriateness Criteria® Breast Implant Evaluation: 2023 Update.

This document discusses the appropriate initial imaging in both asymptomatic and symptomatic patients with breast implants. For asymptomatic patients with saline implants, no imaging is recommended. If concern for rupture exists, ultrasound is usually appropriate though saline rupture is often clinically evident.

Comparison of Contrast-enhanced Mammography with MRI Utilizing an Enriched Reader Study: A Breast Cancer Study (CONTRRAST Trial).

Background Despite growing interest in using contrast-enhanced mammography (CEM) for breast cancer screening as an alternative to breast MRI, limited literature is available. Purpose To determine whether CEM is noninferior to breast MRI or abbreviated breast MRI (AB MRI) and superior to two-dimensional mammography in an asymptomatic population simulating those who would present for screening and then undergo diagnostic work-up. Materials and Methods This enriched reader study used CEM and MRI data prospectively collected from asymptomatic individuals at a single institution from December 2014 to March 2020.

Simultaneous isolation of hormone receptor-positive breast cancer organoids and fibroblasts reveals stroma-mediated resistance mechanisms.

Recurrent hormone receptor-positive (HR+) breast cancer kills more than 600,000 women annually. Although HR+ breast cancers typically respond well to therapies, approximately 30% of patients relapse. At this stage, the tumors are usually metastatic and incurable.

Impact of imaging nurse navigation on breast interventions: Direct and closed-loop patient communication and documentation.

Objective: A breast imaging nurse navigator (NN) was established with the goals to enhance the patient experience after biopsy, improve care timeliness, accuracy, and coordination, facilitate direct communication to patients, and increase care retention within our system. Our aim was to determine the impact of NN on patient care time metrics, communication, documentation, compliance, and care retention at our institution after breast biopsy.

Methods: Retrospective review of a six-month period before (5/1/17-10/31/17) and after (5/1/19-10/31/19) establishment of a nurse navigator in our breast imaging department was performed, including 498 patients in the pre-navigation (pre-NN) group and 526 patients in the post-navigation (post-NN) group.

ACR Appropriateness Criteria® Palpable Breast Masses: 2022 Update.

Palpable masses in women are the most common symptom associated with breast cancer. This document reviews and evaluates the current evidence for imaging recommendations of palpable masses in women less than 30 to over 40 years of age. There is also a review of several different scenarios and recommendations after initial imaging.

ACR Appropriateness Criteria® Imaging After Breast Surgery.

Given that 20% to 40% of women who have percutaneous breast biopsy subsequently undergo breast surgery, knowledge of imaging women with a history of benign (including high-risk) disease or breast cancer is important. For women who had surgery for nonmalignant pathology, the surveillance recommendations are determined by their overall risk. Higher-than-average risk women with a history of benign surgery may require screening mammography starting at an earlier age before 40 and may benefit from screening MRI.

Enhancement Type at Contrast-enhanced Mammography and Association with Malignancy.

Background Despite the increasing use of contrast-enhanced mammography (CEM), there are limited data on the evaluation of findings on recombined images and the association with malignancy. Purpose To determine the rates of malignancy of enhancement findings on CEM images in the presence or absence of low-energy findings using the Breast Imaging Reporting and Data System (BI-RADS) lexicon developed for mammography and MRI. Materials and Methods All diagnostic CEM examinations performed at one academic institution between December 2015 and December 2019 had low-energy and recombined images retrospectively.

Characterization of True and False Positive Findings on Contrast-Enhanced Mammography.

Rationale And Objectives: The purpose of this paper is to characterize true and false positive findings on contrast-enhanced mammography (CEM) and correlate enhancement pattern and method of detection with pathology outcomes.

Materials And Methods: This was an IRB-approved retrospective review of diagnostic CEM performed from December 2015 through December 2019 for which biopsy was recommended. Background parenchymal enhancement, tissue density, finding features, pathologic/clinical outcomes, and method of detection were captured.

Cancer Conspicuity on Low-energy Images of Contrast-enhanced Mammography Compared With 2D Mammography.

Objective: Low-energy (LE) images of contrast-enhanced mammography (CEM) have been shown to be noninferior to digital mammography. However, our experience is that LE images are superior to 2D mammography. Our purpose was to compare cancer appearance on LE to 2D images.

Variation in Breast Cancer Risk Model Estimates Among Women in Their 40s Seen in Primary Care.

The Gail, Breast Cancer Surveillance Consortium (BCSC), and Tyrer-Cuzick breast cancer risk prediction models are recommended for use in primary care. Calculating breast cancer risk is particularly important for women in their 40s when deciding on mammography, with some guidelines recommending screening for those with 5-year risk similar to women age 50 (≥1.1%).

Lineage-specific silencing of PSAT1 induces serine auxotrophy and sensitivity to dietary serine starvation in luminal breast tumors.

A major challenge of targeting metabolism for cancer therapy is pathway redundancy, in which multiple sources of critical nutrients can limit the effectiveness of some metabolism-targeted therapies. Here, we analyze lineage-dependent gene expression in human breast tumors to identify differences in metabolic gene expression that may limit pathway redundancy and create therapeutic vulnerabilities. We find that the serine synthesis pathway gene PSAT1 is the most depleted metabolic gene in luminal breast tumors relative to basal tumors.

ACR Appropriateness Criteria® Transgender Breast Cancer Screening.

Breast cancer screening recommendations for transgender and gender nonconforming individuals are based on the sex assigned at birth, risk factors, and use of exogenous hormones. Insufficient evidence exists to determine whether transgender people undergoing hormone therapy have an overall lower, average, or higher risk of developing breast cancer compared to birth-sex controls. Furthermore, there are no longitudinal studies evaluating the efficacy of breast cancer screening in the transgender population.

Injected Breast Materials: Review of Imaging Features and Characteristics.

In the United States, silicone and saline breast implants with their familiar radiologic appearance are the mainstays of breast augmentation. However, less well-known sequelae of unconventional injected materials introduced for cosmetic and noncosmetic purposes may also be encountered on breast imaging-for example, free silicone, paraffin and/or oil, polyacrylamide gel, autologous fat, and hyaluronic acid, which are encountered in the setting of breast augmentation. Breast injection of go-yak is not cosmetic but also results in characteristic imaging findings.

Upgrade Rates of Pure, Radiology-Pathology Concordant Lobular Neoplasia Diagnosed on Breast Core Needle Biopsy: Is Surgical Excision Warranted?

Objective: To determine upgrade rates of lobular neoplasia (LN) to malignancy and evaluate factors that may predict upgrade.

Methods: From 5/1/2003 to 12/30/2015, breast lesions diagnosed as LN (atypical lobular hyperplasia [ALH] or classic lobular carcinoma in-situ [LCIS]) on core biopsy that underwent surgical excision or at least 2 years imaging follow-up were identified. A subspecialty trained breast radiologist and pathologist reviewed imaging and pathology slides to confirm diagnosis and to determine if LN represented the target lesion, part of the target lesion, or an incidental finding.

Contrast-enhanced Mammography: A Guide to Setting Up a New Clinical Program.

Contrast-enhanced mammography (CEM) is gaining rapid traction following the U.S. Food and Drug Administration approval for diagnostic indications.