Program Information
Clinical Trends in Breast Imaging
C Hruska1*, A Kerger2*, (1) Mayo Clinic, Rochester, MN, (2) The Ohio State University, Columus, OH
Presentations
SU-A-BRC-0 (Sunday, March 19, 2017) 8:00 AM - 10:00 AM Room: Ballroom C
The field of radiology and medical imaging is undergoing rapid changes with the evolution of new imaging modalities and the increasing use of imaging markers and big data to help predict, manage, or even cure diseases, including breast cancer. Regardless of the setting in which they find themselves, by virtue of their scientific training medical physicists will be expected to be conversant with these new technologies and techniques and in many cases contribute their expertise in helping ensure proper clinical implementation.
Detection to Prediction: Imaging Markers of Breast Cancer Risk - C. Hruska, PhD
Mammographic density which is related to the amount of fibroglandular tissue seen on mammography, is known to mask breast cancers from detection. Density is also strongly and independently associated with breast cancer risk. However, density lacks the necessary discriminatory power to be clinically useful as a sole predictor of an individual’s breast cancer risk. In addition, the mechanisms linking density and breast cancer development are still unclear. Thus efforts are underway to identify novel imaging biomarkers in benign breast fibroglandular tissue and to characterize their clinical correlates and relationship to breast cancer risk. A review of research examining breast fibroglandular tissue with functional imaging modalities will be provided, including studies of breast MR imaging, molecular breast imaging, contrast-enhanced mammography, and positron emission tomography. Findings suggest that additional risk information provided by functional imaging may serve to identify the subset of women with dense breast who are most likely to benefit from tailored screening or risk-reduction strategies.
Learning Objectives:
1. The prevalence of and risk factors for breast cancer
2. Which predictive models are used and which imaging markers are useful
3. The inherent challenges of imaging fibroglandular tissue
4. The future of predictive diagnostics in mammography and possible role for medical physicists
A Clinical Perspective on DBT-Guided Stereotactic Breast Biopsy: A. Kerger, MD
2D prone stereotactic breast biopsy has been a mainstay in biopsy of suspicious microcalcifications of the breast and sometimes asymmetries, focal asymmetries, masses and distortion without a sonographic correlate. Although this technique works well, it has inherent limitations with visualization and localization of asymmetries, masses and distortion due to overlapping tissue. With the advent of breast tomosynthesis, we are now able to better visualize and localize these lesions for biopsy under guidance with tomosynthesis . Prone 2D stereotactic biopsy also has pitfalls that are encountered when a patient has physical limitations (patient is over the table weight limit or unable to get up onto the table or lay on her stomach). 3D Tomosynthesis guided biopsy has the advantage of being able to perform biopsy in the upright positioning, eliminating these limitations. In addition, a new prone table has been marketed that also does 2D and tomosynthesis stereotactic biopsies that allow more options for localization and biopsy of a lesion.
Learning Objectives:
1. How tomosynthesis guided breast biopsy compares with 2D stereotactic guided biopsy
2. Clinical indicators for use of tomosynthesis guided biopsy compared to 2D stereotactic biopsy
3. Advantages and disadvantages of tomosynthesis guided biopsy in comparison to conventional methods
4. The clinical advantages of the new prone tomosynthesis/2D table
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