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Three Ways to Maximize Your CAD Experience with Clinical Breast Imaging

March 1, 2009
Written by: , Filed in: Breast Imaging
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How exactly can computer-aided detection in mammography (CAD) improve your clinical breast imaging reading accuracy?

There are obvious ways: training, repetition, and formal mammography CME courses.

Here are three not-so-obvious tips you can use to capitalize on improved clinical breast imaging technology.

First, conscientious clinical breast imaging requires you to closely examine the patient’s latest image, and second, to review her previous images. CAD makes this easier and is a great “heads up” system for the radiologist.

When I’m doing diagnostic workups and the technologist brings me the film of a patient who has had a lumpectomy and has returned for a routine follow-up, I could just do a simple reading and say, “It’s negative; see you in a year.” But I don’t dismiss the case so quickly. Rather, I dig into the film.

A review of all previous clinical breast imaging is the best way to look at a lot of cancers, especially when the patient has a folder and you know she had a cancer in the past. Spend a few minutes longer. Look at all the cancers. And pull out the images from the previous year, too, to review some of the subtle signs.

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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

Similarly, when using digital images, if your patient previously has had a lumpectomy or cystectomy, you can bring up her prior digital clinical breast imaging for review, for better breast cancer detection.

At our school, we facilitate mammography CME by maintaining teaching files. We categorize each image by physician, mark every screening cancer, and then anonymize the entire set. As part of their mammography CME, as residents come through rotation, we have them look through at least 50 clinical breast imaging files of patients who have cancers.

We regularly measure the detection accuracy to determine how well the young physicians improve over time. It’s a great clinical breast imaging learning experience and a genuine, hands-on supplement to textbook mammography CME.

Here’s a third tip: Set up a routine review of previously false negative readings. Anytime you’re dealing with pathology on core biopsies, a routine, monthly review of patients’ previous mammograms is in order.

The beauty of digital technology in clinical breast imaging is that it facilitates a review of false negatives and all of a patient’s previous images.

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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