RESUMEN
RATIONALE AND OBJECTIVES: Our purpose is to understand patient preferences towards contrast-enhanced imaging such as CEM or MRI for breast cancer screening. METHODS AND MATERIALS: An anonymous survey was offered to all patients having screening mammography at a single academic institution from December 27 th 2019 to March 6 th 2020. Survey questions related to: (1) patients' background experiences (2) patients' concern for aspects of MRI and CEM measured using a 5-point Likert scale, and (3) financial considerations. RESULTS: 75% (1011/1349) patients completed the survey. 53.0% reported dense breasts and of those, 47.6% had additional screening. 49.6% had experienced a callback, 29.0% had a benign biopsy, and 13.7% had prior CEM/MRI. 34.7% were satisfied with mammography for screening. A majority were neutral or not concerned with radiation exposure, contrast allergy, IV line placement, claustrophobia, and false positive exams. 54.7% were willing to pay at least $250-500 for screening MRI. Those reporting dense breasts were less satisfied with mammography for screening (p<0.001) and willing to pay more for MRI (p<0.001). If patients had prior CEM/MRI, there was less concern for an allergic reaction (p<0.001), IV placement (p=0.025), and claustrophobia (p=0.006). There was less concern for false positives if they had a prior benign biopsy (p=0.029) or prior CEM/MRI (p=0.005) and less concern for IV placement if they had dense breasts (p=0.007) or a previous callback (p=0.013). CONCLUSION: The screening population may accept CEM or MRI as a screening exam despite its risks and cost, especially patients with dense breasts and patients who have had prior CEM/MRI.
Asunto(s)
Neoplasias de la Mama , Mama/diagnóstico por imagen , Densidad de la Mama , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/patología , Medios de Contraste , Detección Precoz del Cáncer/métodos , Femenino , Humanos , Imagen por Resonancia Magnética , Mamografía/métodos , Tamizaje Masivo , Prioridad del Paciente , Sensibilidad y EspecificidadRESUMEN
OBJECTIVE: To survey Society of Breast Imaging (SBI) membership on their use of abbreviated breast MRI to understand variability in practice patterns. METHODS: A survey was developed by the SBI Patient Care and Delivery committee for distribution to SBI membership in July and August 2021. Eighteen questions queried practice demographics and then abbreviated breast MRI practices regarding initial adoption, scheduling and finances, MRI protocols, and interpretations. Comparisons between responses were made by practice demographics. RESULTS: There were 321 respondents (response rate: 15.3%), of whom 25% (81/321) currently offer and 26% (84/321) plan to offer abbreviated breast MRI. Practices in the South (37/107, 35%) and Midwest (22/70, 31%) were more likely to offer abbreviated MRI (Pâ =â 0.005). Practices adopted many strategies to raise awareness, most directed at referring providers. The mean charge to patients was $414, and only 6% of practices offer financial support. The median time slot for studies is 20 minutes, with only 15% of practices using block scheduling of consecutive breast MRIs. Regarding MRI protocols, 64% (37/58) of respondents included only a single first-pass post-contrast sequence, and 90% (52/58) included T2-weighted sequences. Patient eligibility was highly varied, and a majority of respondents (37/58, 64%) do not provide any recommendations for screening intervals in non-high-risk women. CONCLUSION: Abbreviated breast MRI utilization is growing rapidly, and practices are applying a variety of strategies to facilitate adoption. Although there is notable variability in patient eligibility, follow-up intervals, and costs, there is some agreement regarding abbreviated breast MRI protocols.
Asunto(s)
Mama , Imagen por Resonancia Magnética , Femenino , Humanos , Mama/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Encuestas y CuestionariosRESUMEN
Breast lymphoma is a rare hematologic neoplasm that originates in the breast lymphoid tissue and includes primary breast lymphoma (PBL) and secondary breast lymphoma (SBL). PBL involves the breast lymphoid tissue in the absence of previously identified extramammary lymphoma and widespread disease. SBL is the most common metastasis to the breast, accounting for 17% of metastatic disease to the breast. PBL and SBL usually demonstrate imaging phenotypes that overlap with those of primary breast carcinoma, which makes a prospective diagnosis of breast lymphoma challenging. These nonspecific imaging features include an iso- to hyperdense oval mass or masses at mammography, a hypoechoic or mixed-echogenicity hypervascular mass at US, an enhancing mass with type II kinetics at MRI, and high fluorine 18-fluorodeoxyglucose avidity at PET. In cases of suspected lymphoma, reviewing the clinical history, using appropriate biopsy techniques, and evaluating for multiplicity, bilaterality, and distant disease are critical for diagnosis and management. A patient with PBL generally has an earlier clinical presentation with a palpable abnormality and a solitary imaging finding. In contrast, multiple masses in an older patient and an occult clinical presentation favor an SBL diagnosis. ©RSNA, 2019.