Breast Cancer Screening and Outcomes Disparities Persist for Native American Women.

Over the past three decades, mortality rates from breast cancer have decreased for multiple racial groups but have remained constant for American Indian and Alaskan Native (AI/AN) women. Additionally, AI/AN women are less likely to receive timely breast cancer screening and are more likely to be diagnosed with advanced stage breast cancer at younger ages than their White counterparts. These disparities can be explained, in part, by the unique barriers to accessing care faced by AI/AN women.

Optimizing the Patient Experience in Breast Imaging Facilities: Expert Panel Narrative Review.

Breast imaging studies are complex examinations for patients and providers. Breast imaging providers and organizations invest significant resources in educating patients and referring physicians to address variability in changing breast cancer screening recommendations, cultural biases, and socioeconomic barriers for patients. The breast imaging examination frequently involves multiple imaging modalities, including interventional procedures, thus requiring multiple room types.

An Asset-Based Quality Improvement Tool for Health Care Organizations: Cultivating Organizationwide Quality Improvement and Health Care Professional Engagement.

In the United States, health care organizations are often biased toward deficit-based quality and safety improvement techniques, such as incident reporting and peer review. However, deficit-based techniques may elicit negative sentiments from frontline health care professionals, causing disengagement and adverse event underreporting. To complement deficit-based quality improvement, our institution developed an organizationwide asset-based quality improvement tool.

Antithrombotic Therapy and Hematoma Risk during Image-guided Core-Needle Breast Biopsy.

Background For image-guided core-needle breast biopsy (CNBB), it remains unclear whether antithrombotic medication should be withheld because of hematoma risk. Purpose To determine hematoma risk after CNBB in patients receiving antithrombotic medication and to stratify risk by antithrombotic type. Materials and Methods This HIPAA-compliant retrospective study included US-, stereotactic-, or MRI-guided CNBBs performed across six academic and six private practices between April 2019 and April 2021.

Patient-centered Care and Integrated Practice Units: Embracing the Breast Care Continuum.

Patient-centered care is a health care approach optimized for the needs of the patient. As patients have sought more autonomy in recent years, this model has been more frequently adopted. Breast radiologists aspiring to advance patient-centered care should seek greater ownership of the breast diagnostic imaging and intervention workflows, helping their patients navigate the complex breast care landscape with patients' preferences taken into account.

Anxiety and Its Association With Screening Mammography.

Anxiety is often cited as a risk of screening mammography, and organizations such as the U.S. Preventive Services Task Force list anxiety as a screening-associated "harm" that should be mitigated.

A Breast Radiology Department-operated, Proactive Same-day Program Identifies Pathogenic Breast Cancer Mutations in Unaffected Women.

Rationale And Objectives: Pathogenic mutations in some genes elevate women's breast cancer risk, necessitating risk-reduction strategies. Unfortunately, women are underscreened for cancer risk, and when identified as potentially high risk, women seldom pursue genetic counseling or testing. To improve cancer risk management, this project determined the feasibility of radiology-operated, proactive, same-day risk assessment and genetic testing programs to diagnose high-risk women undergoing breast imaging.

Collaborative interdepartmental teams: benefits, challenges, alternatives, and the ingredients for team success.

Radiology practices often employ collaborative interdepartmental teams to address complex projects. These teams benefit from their diversity of viewpoints and the potential for innovative, high-quality solutions. However, collaborative interdepartmental teams also suffer from challenges: interpersonal conflicts, team member mistrust, competing individual priorities, and obstructive turf concerns.

The Role of Cognitive Bias in Breast Radiology Diagnostic and Judgment Errors.

Cognitive bias is an unavoidable aspect of human decision-making. In breast radiology, these biases contribute to missed or erroneous diagnoses and mistaken judgments. This article introduces breast radiologists to eight cognitive biases commonly encountered in breast radiology: anchoring, availability, commission, confirmation, gambler's fallacy, omission, satisfaction of search, and outcome.

Enhancing the Value Chain to Increase Customer Satisfaction and Build Successful Breast Imaging Practices.

The US health care industry is increasingly shifting to a value seeking mindset. The breast imaging value chain elucidates how breast imaging radiologists generate and deliver value to their customers, who include both patients and referring health care providers. The breast imaging value chain can be used by radiologists to improve operational effectiveness and to plan new value creation strategically.

Call For Help! The Importance of Role Delineation in a Standardized Contrast Media Emergency Response Protocol.

With the use of intravenous contrast in medical imaging, radiologists and radiology personnel will inevitably encounter adverse events at their imaging facilities. At our institution, the stress of these emergency scenarios led to disorderly and unsafe responses by the staff. We present a quality improvement project, where our team addressed these unsafe emergency responses.

Nipple Discharge: Imaging Variability Among U.S. Radiologists.

Objective: The purpose of this study was to assess radiologists' choice of imaging modality for the evaluation of clinical symptoms of physiologic nipple discharge (e.g., bilateral discharge, multiple-duct orifices, and yellow, green, or white color) and pathologic nipple discharge (e.

Time Is Not on Our Side: How Radiology Practices Should Manage Customer Queues.

As health care shifts toward patient-centered care, wait times have received increasing scrutiny as an important metric for patient satisfaction. Long queues form when radiology practices inefficiently service their customers, leading to customer dissatisfaction and a lower perception of value. This article describes a four-step framework for radiology practices to resolve problematic queues: (1) analyze factors contributing to queue formation; (2) improve processes to reduce service times; (3) reduce variability; (4) address the psychology of queues.

Preoperative Breast MRI: Surgeons' Patient Selection Patterns and Potential Bias in Outcomes Analyses.

Objective: The purpose of this study is to determine which patient- and tumor-related and clinical variables influence dedicated breast surgeons' and general surgeons' referrals for preoperative breast MRI for patients with newly diagnosed breast cancer.

Materials And Methods: Surgeons who perform breast surgery responded to a survey from June 16, 2014, through August 11, 2014. Participants self-identified as breast or general surgeons and provided professional practice details.

Monte Carlo simulation to analyze the cost-benefit of radioactive seed localization versus wire localization for breast-conserving surgery in fee-for-service health care systems compared with accountable care organizations.

Objective: In breast-conserving surgery for nonpalpable breast cancers, surgical reexcision rates are lower with radioactive seed localization (RSL) than wire localization. We evaluated the cost-benefit of switching from wire localization to RSL in two competing payment systems: a fee-for-service (FFS) system and a bundled payment system, which is typical for accountable care organizations.

Materials And Methods: A Monte Carlo simulation was developed to compare the cost-benefit of RSL and wire localization.

Accuracy and value of breast ultrasound for primary imaging evaluation of symptomatic women 30-39 years of age.

Objective: The purpose of this study was to determine the accuracy and value of breast ultrasound for primary imaging evaluation of women 30-39 years of age who present with focal breast signs or symptoms.

Methods: We identified all women 30-39 years of age who underwent imaging evaluation (ultrasound and mammography) at our institution between January 1, 2002, and August 31, 2006, for focal breast signs or symptoms. Each area of concern was designated a study case.

Targeted ultrasound in women younger than 30 years with focal breast signs or symptoms: outcomes analyses and management implications.

Objective: The purpose of this article is to assess the accuracy of targeted breast ultrasound in women younger than 30 years presenting with focal breast signs or symptoms.

Materials And Methods: Retrospective review of the electronic medical records identified all ultrasound examinations from January 1, 2002, through August 30, 2006, performed for focal breast signs or symptoms in women younger than 30 years. BI-RADS assessments were recorded.

Scaphoid Fracture Fixation with an Acutrak(®) Screw.

We report a case of fixation of a scaphoid fracture using an Acutrak(®) screw. This screw is cannulated and headless, which allows it to be implanted below the surface of the bone. It uses the same concept of variable thread pitch as the Herbert screw, but unlike the Herbert screw, is fully threaded, with continuously varying pitch along its length.

Potential of dual-time-point imaging to improve breast cancer diagnosis with (18)F-FDG PET.

Unlabelled: The purpose of this study was to assess the utility of dual-time-point imaging for identifying malignant lesions in the breast by (18)F-FDG PET.

Methods: Fifty-four breast cancer patients with 57 breast lesions underwent 2 sequential PET scans (dual-time-point imaging). The average percent change in standardized uptake values (SUVs) between time point 1 and time point 2 was calculated.

User-defined vascular input function curves: influence on mean perfusion parameter values and signal-to-noise ratio.

The authors reviewed 40 computed tomographic (CT) perfusion studies to determine the effect of arterial and venous input function properties on perfusion parameter values and tissue signal-to-noise ratio (SNR). A 10-subject subset was analyzed to evaluate the effect of varying venous region of interest (ROI) locations. Venous peak enhancement correlated significantly with mean tissue cerebral blood flow (CBF) and cerebral blood volume (CBV); venous and arterial peak enhancement correlated significantly with SNR of perfusion maps.