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Breast Imaging CME: Three Tips for Improving Breast Cancer Detection in Mammograms

March 2, 2009
Written by: , Filed in: Breast Imaging
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Nothing can replace the basic skills of knowing the signs of breast cancer and recognizing them. That’s fundamental.

But there are some tips for improving accuracy in reading mammograms.

Breast imaging CME Tip #1: First, minimize distractions for maximum effectiveness.

Ideally, you want to be in a setting where you’re reading screening mammograms uninterrupted. Some radiologists go in early, close the door and don’t take phone calls. That works in some settings, but unfortunately is not the real world in others.

You may have no choice but to try to read mammograms and do diagnostics at the same time. Technologists are constantly coming in, interrupting you, which can lead to the potential for overlooking something, or forgetting to look at a particular view, making your screening less accurate and efficient.

At our center, we try to assign two radiologists to work together. One radiologist does diagnostics and ultrasounds and talks to the patients. The other radiologist has some scheduled biopsies, but also reads the mammograms. Each knows when during the day she is going to be uninterrupted, and has a block of time to exclusively read the mammograms.

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Related CME

Women's Imaging
University of California San Francisco, Department of Radiology

  The overall goal of this program is to provide current information on the relevant use of imaging and interventional techniques in women with breast and gynecologic pathology. Core concepts and future directions are addressed, including cancer screening, breast intervention, and current status of breast and gynecologic MRI. Up to 20.75 AMA PRA Category 1 Credit(s)™ are available.
Read more or order: Women's Imaging

Imaging Review: Body, Bone & Breast
University of California, San Francisco, Department of Radiology
  This program is designed for the radiologist in clinical practice, and is intended to provide an overview and update on clinically relevant topics in diagnostic imaging, as well as an up-to-date assessment of the clinical uses of modern imaging modalities such as CT, MR and ultrasound. 20 AMA PRA Category 1 Credit(s)™ are available.
  Read more or order: Imaging Review: Body, Bone & Breast

Breast imaging CME Tip #2: Second, don’t spend too much time dwelling on the mammogram after your initial assessment — it really doesn’t change detection.

A couple of studies about skill level in detecting breast cancer indicate that as detection skills increase, prolonged concentration on a film is unnecessary. One study showed that global assessment by skilled radiologists was the most accurate, and that spending more time didn’t improve the accuracy. In fact, spending more time actually increased some false negatives.

Breast imaging CME Tip #3: Third, and obviously, nothing replaces experience when it comes to recognizing breast cancer as evinced on a mammogram.

Studies have shown that experienced mammographers tend to detect most of the cancers within the first 25 seconds and overall, have a higher level of detection. No surprises there. Trainees, residents and fellows spend more time looking, but this added time actually yields fewer lesions and increases the risk of false positives.

Eye mapping studies show what readers are looking at. In one study, trainees focused longer on the subareolar breast, whereas when more experienced radiologists looked at the same area, they quickly moved on. Nevertheless, the latter were better at finding cancer.

Practice may not make perfect, but in reference to breast imaging, focused, concentrated assessment of mammograms, and experience in reading mammograms, certainly does increase the accurate detection of breast cancer in patients.

Author: Jessica W. T. Leung, MD

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Related CME
Women’s Imaging

University of California San Francisco, Department of Radiology
The overall goal of this program is to provide current information on the relevant use of imaging and interventional techniques in women with breast and gynecologic pathology. Core concepts and future directions are addressed, including cancer screening, breast intervention, and current status of breast and gynecologic MRI.
Up to 20.75 AMA PRA Category 1 Credit(s)™ are available.
Read more or order: Women’s Imaging


Imaging Review: Body, Bone & Breast

University of California, San Francisco, Department of Radiology
This program is designed for the radiologist in clinical practice, and is intended to provide an overview and update on clinically relevant topics in diagnostic imaging, as well as an up-to-date assessment of the clinical uses of modern imaging modalities such as CT, MR and ultrasound. 20 AMA PRA Category 1 Credit(s)™ are available.
Read more or order: Imaging Review: Body, Bone & Breast

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