1
|
Slanetz PJ, Jarvik JG, Bailey JE, McGinty GB. Strategies for Radiology to Improve Population Health. J Am Coll Radiol 2024; 21:691-693. [PMID: 37495030 DOI: 10.1016/j.jacr.2023.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 01/24/2023] [Indexed: 07/28/2023]
Affiliation(s)
- Priscilla J Slanetz
- Vice Chair of Academic Affairs in the Department of Radiology and Associate Program Director of the Diagnostic Radiology Residency, Department of Radiology, Boston University Medical Center, Boston, Massachusetts, and from the Boston University School of Medicine, Boston, Massachusetts; Director, Early Career Faculty Development and Co-Director of the Academic Writing Program for Boston University Medical Group; Past-President, Massachusetts Radiological Society; President, Association of University Radiologists; and Subspecialty Chair, ACR Appropriateness Criteria Breast Imaging Panels.
| | - Jeffrey G Jarvik
- Departments of Radiology and Neurological Surgery, University of Washington School of Medicine, Seattle, Washington; Director of the University of Washington Clinical Learning, Evidence, and Research Center for Musculoskeletal Disorders; and President-Elect, Association of University Radiologists
| | - Janet E Bailey
- Associate Chair for Education, Associate Program Director of the Integrated Interventional Radiology Residency, and Division Director of Breast Imaging at the University of Michigan Department of Radiology, University of Michigan Medical Center, Ann Arbor, Michigan; chairs the ACGME Radiology Residency Review Committee; Past President of the Association of University Radiologists and the Association of Program Directors in Radiology
| | - Geraldine B McGinty
- Senior Associate Dean for Clinical Affairs, Departments of Radiology and Population Health Sciences, Weill Cornell Medicine, New York, New York; past chair of the ACR's Board of Chancellors as well as a past President of the Society
| |
Collapse
|
2
|
Mullen LA, Weinfurtner RJ, Borovicka KM, Hoyt TL, Letter HP, O'Brien SR, Swamy N, Vicenti KL, Woodard SA, Xavier BA, Gundry KR, Merkulov A, Margolies LR, Slanetz PJ. Maximizing Mentorship Throughout Your Breast Imaging Career. J Breast Imaging 2024:wbae009. [PMID: 38554120 DOI: 10.1093/jbi/wbae009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Indexed: 04/01/2024]
Abstract
Unlike many other subspecialties in radiology, breast radiologists practice in a patient-facing and interdisciplinary environment where team building, communication, and leadership skills are critical. Although breast radiologists can improve these skills over time, strong mentorship can accelerate this process, leading to a more successful and satisfying career. In addition to providing advice, insight, feedback, and encouragement to mentees, mentors help advance the field of breast radiology by contributing to the development of the next generation of leaders. During the mentorship process, mentors continue to hone their listening, problem-solving, and networking skills, which in turn creates a more supportive and nurturing work environment for the entire breast care team. This article reviews important mentorship skills that are essential for all breast radiologists. Although some of the principles apply to all mentoring relationships, ensuring that every breast radiologist has the skills to be both an effective mentor and mentee is key to the future of the profession.
Collapse
Affiliation(s)
- Lisa A Mullen
- Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - R Jared Weinfurtner
- Diagnostic Imaging and Interventional Radiology, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Tamarya L Hoyt
- Clinical Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Haley P Letter
- Department of Radiology, Mayo Clinic, Jacksonville, FL, USA
| | - Sophia R O'Brien
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Kerri L Vicenti
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Stefanie A Woodard
- Department of Radiology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Brian A Xavier
- Imaging Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Kathleen R Gundry
- Department of Radiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Alex Merkulov
- Department of Radiology, University of Connecticut Health, Farmington, CT, USA
| | - Laurie R Margolies
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | |
Collapse
|
3
|
Belfi LM, Averill S, Benefield T, Jordan SG, Slanetz PJ. Understanding the Role of Resilience and Self-Compassion in Radiologist Well-Being. J Am Coll Radiol 2024; 21:528-537. [PMID: 37838188 DOI: 10.1016/j.jacr.2023.02.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 11/30/2022] [Accepted: 02/07/2023] [Indexed: 10/16/2023]
Affiliation(s)
- Lily M Belfi
- Director of Medical Student Education, Division of Emergency/Musculoskeletal Radiology, Department of Radiology, Weill Cornell Medicine, New York, New York.
| | - Sarah Averill
- Department of Radiology, Iowa City VA Health Care System, Iowa City, Iowa
| | - Thad Benefield
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Sheryl G Jordan
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Priscilla J Slanetz
- Department of Radiology, Boston University School of Medicine, Boston, Massachusetts; is President-Elect of the Association of University Radiologists; and is Subspecialty Chair, ACR Appropriateness Criteria Breast Imaging Panels
| |
Collapse
|
4
|
Cooke EA, Chan S, Belfi L, Slanetz PJ. Enriching Radiology through Collective Creativity. Acad Radiol 2024; 31:349-350. [PMID: 38242730 DOI: 10.1016/j.acra.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/04/2024] [Accepted: 01/04/2024] [Indexed: 01/21/2024]
Affiliation(s)
- Erin A Cooke
- Vanderbilt University Medical Center, Department of Radiology, 1161 21st Ave. S., Nashville, TN 37232 (E.A.C.)
| | - Stephen Chan
- Division of Neuroradiology, Columbia University Medical Center, Vagelos College of Physicians and Surgeons, Harlem Hospital Center, Department of Radiology, 506 Lenox Ave, New York, NY 10037 (S.C.)
| | - Lily Belfi
- Division of Emergency/ Musculoskeletal Radiology, Weill Cornell Medicine, 525 East 68th Street, Room F-054, New York, NY 10065 (L.B.)
| | - Priscilla J Slanetz
- Boston University, Boston Medical Center, One Boston Medical Center Place, Boston, MA 02118 (P.J.S.)
| |
Collapse
|
5
|
Slanetz PJ, Albasha H, Gomez E, Schaefer P. Unionization and the Impact on Radiology Resident Education. J Am Coll Radiol 2024; 21:360-362. [PMID: 37734689 DOI: 10.1016/j.jacr.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 09/15/2023] [Indexed: 09/23/2023]
Affiliation(s)
- Priscilla J Slanetz
- Diagnostic Radiology Residency, Department of Radiology, Boston University Medical Center, Boston, Massachusetts; Boston University School of Medicine, Boston, Massachusetts.
| | - Heba Albasha
- Department of Radiology, University of Cincinnati, Cincinnati, Ohio; Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Erin Gomez
- Program Director of the Diagnostic Radiology and Molecular Imaging Residencies, Department of Radiology, Johns Hopkins Hospital, Baltimore, Maryland
| | - Pamela Schaefer
- Department of Radiology, Massachusetts General Hospital and Massachusetts General Brigham, Boston, Massachusetts
| |
Collapse
|
6
|
Lopez AR, Slanetz PJ, Narayan A, Tran NT, Porras AR, Miles RC. Erratum for: Assessing the Relationship between Radiology Department Research Funding and Institutional Community Inclusion and Investment. Radiology 2024; 310:e249003. [PMID: 38411525 DOI: 10.1148/radiol.249003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
|
7
|
Belfi LM, Slanetz PJ, Cooke EA, Chan S, Frederick-Dyer K, Ataya D, Choe AI, Deitte LA. Creativity, Connection, and Community: Reimagining the Radiology Society Meeting. Acad Radiol 2024; 31:351-359. [PMID: 38401980 DOI: 10.1016/j.acra.2023.10.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/09/2023] [Accepted: 10/13/2023] [Indexed: 02/26/2024]
Abstract
RATIONALE AND OBJECTIVES With the shifting needs of radiologists due to escalating healthcare demands, the impetus for an increased focus on wellness and the benefits of the humanities in medicine inspired a novel approach to curricular planning of the 2023 Association of University Radiologists (AUR) annual meeting. In this manuscript, we describe the creative process behind planning and executing this innovative meeting format. MATERIALS AND METHODS Reimagining the annual meeting was a collaborative effort centered around the development of an innovative Arts and Wellness Program, with the goal of integrating opportunities for artistic expression and experiential wellness throughout the meeting. RESULTS Of the 1313 meeting attendees, 423 (32.2%) completed the annual meeting evaluation, of which 244 were in-person and 61 attended virtually. 178 of 423 respondents (42.1%) participated in the arts and wellness programming. 160 of 203 respondents (78.9%) reported that the arts and wellness programming enhanced the overall meeting experience. 164 of 197 respondents (83.2%) gained greater appreciation for the talents of radiology colleagues. 97 of 195 respondents (49.7%) stated that the programming gave them ideas as to how to cope effectively with stress. CONCLUSION The incorporation of art, music, and other wellness activities into a national radiology meeting was well-received by meeting attendees. For many radiologists who participated in the various musical and artistic offerings at the AUR 2023 meeting, sharing artistic talents with the radiology community and colleagues represented the most fundamental way to be fully seen, express authenticity, and connect with others.
Collapse
Affiliation(s)
- Lily M Belfi
- Department of Radiology, Weill Cornell Medicine, 525 East 68th Street, Room F-054, New York, New York, USA (L.M.B.).
| | - Priscilla J Slanetz
- Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA (P.J.S.)
| | - Erin A Cooke
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA (E.A.C., K.F.D., L.A.D.)
| | - Stephen Chan
- Department of Radiology, Harlem Hospital Center and Columbia University, New York, New York, USA (S.C.)
| | - Katherine Frederick-Dyer
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA (E.A.C., K.F.D., L.A.D.)
| | - Dana Ataya
- Department of Radiology, Moffitt Cancer Center, Tampa, Florida, USA (D.A.)
| | - Angela I Choe
- Department of Radiology, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA (A.I.C.)
| | - Lori A Deitte
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA (E.A.C., K.F.D., L.A.D.)
| |
Collapse
|
8
|
Deitte LA, Naeger DM, Slanetz PJ, Geer CP. The Good, the Bad, and the Ugly: Mentors and Antimentors. J Am Coll Radiol 2024:S1546-1440(23)00750-0. [PMID: 37820842 DOI: 10.1016/j.jacr.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 10/03/2023] [Indexed: 10/13/2023]
Affiliation(s)
- Lori A Deitte
- Vice Chair of Education, Department of Radiology and Radiological Sciences, and Vice President for Continuous Professional Development, Vanderbilt University Medical Center, Nashville, Tennessee.
| | - David M Naeger
- Professor, Director of Radiology, Department of Radiology, Denver Health and Hospital Authority, Denver, Colorado
| | - Priscilla J Slanetz
- Vice Chair of Academic Affairs and Associate Program Director of Diagnostic Radiology Residency, Department of Radiology, and Program Director, Early Career Faculty Development and Academic Writing for Boston University Medical Group, Boston University Medical Center, Boston, Massachusetts
| | - Carol P Geer
- Associate Professor of Radiology, Diagnostic Radiology Residency Program Director, Department of Radiology, Wake Forest University School of Medicine, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, North Carolina
| |
Collapse
|
9
|
Slanetz PJ. Addressing Educational Gaps in Transgender Imaging Care. Acad Radiol 2024; 31:304-305. [PMID: 37973513 DOI: 10.1016/j.acra.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023]
Affiliation(s)
- Priscilla J Slanetz
- Boston University School of Medicine and Department of Radiology, Boston University Medical Center, 820 Harrison Avenue, FGH-4, Boston, MA 02118.
| |
Collapse
|
10
|
Lopez AR, Slanetz PJ, Narayan A, Tran NT, Porras AR, Miles RC. Assessing the Relationship between Radiology Department Research Funding and Institutional Community Inclusion and Investment. Radiology 2024; 310:e231469. [PMID: 38259205 DOI: 10.1148/radiol.231469] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Background Health care access disparities and lack of inclusion in clinical research have been well documented for marginalized populations. However, few studies exist examining the research funding of institutions that serve historically underserved groups. Purpose To assess the relationship between research funding awarded to radiology departments by the National Institutes of Health (NIH) and Lown Institute Hospitals Index rankings for inclusivity and community benefit. Materials and Methods This retrospective study included radiology departments awarded funding from the NIH between 2017 and 2021. The 2021 Lown Institute Hospitals Index rankings for inclusivity and community benefit were examined. The inclusivity metric measures how similar a hospital's patient population is to the surrounding community in terms of income, race and ethnicity, and education level. The community benefit metric measures charity care spending, Medicaid as a proportion of patient revenue, and other community benefit spending. Linear regression and Pearson correlation coefficients (r values) were used to evaluate the relationship between aggregate NIH radiology department research funding and measures of inclusivity and community benefit. Results Seventy-five radiology departments that received NIH funding ranging from $195 000 to $216 879 079 were included. A negative correlation was observed between the amount of radiology department research funding received and institutional rankings for serving patients from racial and/or ethnic minorities (r = -0.34; P < .001), patients with low income (r = -0.44; P < .001), and patients with lower levels of education (r = -0.46; P < .001). No correlation was observed between the amount of radiology department research funding and institutional rankings for charity care spending (r = -0.19; P = .06), community investment (r = -0.04; P = .68), and Medicaid as a proportion of patient revenue (r = -0.10; P = .22). Conclusion Radiology departments that received more NIH research funding were less likely to serve patients from racial and/or ethnic minorities and patients who had low income or lower levels of education. © RSNA, 2024 See also the editorial by Mehta and Rosen in this issue.
Collapse
Affiliation(s)
- Antonio R Lopez
- From Drexel University College of Medicine, Philadelphia, Pa (A.R.L.); Department of Radiology, Boston Medical Center, Boston, Mass (P.J.S.); Boston University Chobanian & Avedisian School of Medicine, Boston, Mass (P.J.S.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (A.N.); Department of Radiology, Denver Health, 777 Bannock St, Denver, CO 80204 (N.T.T., R.C.M.); Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colo (A.R.P.); Departments of Pediatric Plastic & Reconstructive Surgery and Neurosurgery, Children's Hospital Colorado, Aurora, Colo (A.R.P.); and Departments of Pediatrics, Surgery, and Biomedical Informatics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colo (A.R.P.)
| | - Priscilla J Slanetz
- From Drexel University College of Medicine, Philadelphia, Pa (A.R.L.); Department of Radiology, Boston Medical Center, Boston, Mass (P.J.S.); Boston University Chobanian & Avedisian School of Medicine, Boston, Mass (P.J.S.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (A.N.); Department of Radiology, Denver Health, 777 Bannock St, Denver, CO 80204 (N.T.T., R.C.M.); Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colo (A.R.P.); Departments of Pediatric Plastic & Reconstructive Surgery and Neurosurgery, Children's Hospital Colorado, Aurora, Colo (A.R.P.); and Departments of Pediatrics, Surgery, and Biomedical Informatics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colo (A.R.P.)
| | - Anand Narayan
- From Drexel University College of Medicine, Philadelphia, Pa (A.R.L.); Department of Radiology, Boston Medical Center, Boston, Mass (P.J.S.); Boston University Chobanian & Avedisian School of Medicine, Boston, Mass (P.J.S.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (A.N.); Department of Radiology, Denver Health, 777 Bannock St, Denver, CO 80204 (N.T.T., R.C.M.); Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colo (A.R.P.); Departments of Pediatric Plastic & Reconstructive Surgery and Neurosurgery, Children's Hospital Colorado, Aurora, Colo (A.R.P.); and Departments of Pediatrics, Surgery, and Biomedical Informatics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colo (A.R.P.)
| | - Nhat-Tuan Tran
- From Drexel University College of Medicine, Philadelphia, Pa (A.R.L.); Department of Radiology, Boston Medical Center, Boston, Mass (P.J.S.); Boston University Chobanian & Avedisian School of Medicine, Boston, Mass (P.J.S.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (A.N.); Department of Radiology, Denver Health, 777 Bannock St, Denver, CO 80204 (N.T.T., R.C.M.); Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colo (A.R.P.); Departments of Pediatric Plastic & Reconstructive Surgery and Neurosurgery, Children's Hospital Colorado, Aurora, Colo (A.R.P.); and Departments of Pediatrics, Surgery, and Biomedical Informatics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colo (A.R.P.)
| | - Antonio R Porras
- From Drexel University College of Medicine, Philadelphia, Pa (A.R.L.); Department of Radiology, Boston Medical Center, Boston, Mass (P.J.S.); Boston University Chobanian & Avedisian School of Medicine, Boston, Mass (P.J.S.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (A.N.); Department of Radiology, Denver Health, 777 Bannock St, Denver, CO 80204 (N.T.T., R.C.M.); Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colo (A.R.P.); Departments of Pediatric Plastic & Reconstructive Surgery and Neurosurgery, Children's Hospital Colorado, Aurora, Colo (A.R.P.); and Departments of Pediatrics, Surgery, and Biomedical Informatics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colo (A.R.P.)
| | - Randy C Miles
- From Drexel University College of Medicine, Philadelphia, Pa (A.R.L.); Department of Radiology, Boston Medical Center, Boston, Mass (P.J.S.); Boston University Chobanian & Avedisian School of Medicine, Boston, Mass (P.J.S.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (A.N.); Department of Radiology, Denver Health, 777 Bannock St, Denver, CO 80204 (N.T.T., R.C.M.); Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colo (A.R.P.); Departments of Pediatric Plastic & Reconstructive Surgery and Neurosurgery, Children's Hospital Colorado, Aurora, Colo (A.R.P.); and Departments of Pediatrics, Surgery, and Biomedical Informatics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colo (A.R.P.)
| |
Collapse
|
11
|
Huppe AI, Loving VA, Slanetz PJ, Destounis S, Brem RF, Margolies LR. Optimizing the Patient Experience in Breast Imaging Facilities: AJR Expert Panel Narrative Review. AJR Am J Roentgenol 2023. [PMID: 37966035 DOI: 10.2214/ajr.23.29995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
Breast imaging studies are complex examinations for patients and providers. Breast imaging providers and organizations invest significant resources in educating patients and referring providers 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. Practices need to consider variables that affect workflow efficiency throughout the process of scheduling, examination performance, interpretation, and results delivery, as well as options in facilities design to create inviting yet functional environments for patients. Breast imaging appointments provide opportunity to capture individual breast cancer risk and to engage patients in health education and breast screening awareness. This AJR Expert Panel Narrative Review discusses ways in which breast imaging facilities can optimize patient experience throughout the complex process of a breast imaging examination, based on the authors' observations and opinions that include private and academic breast imaging experience.
Collapse
|
12
|
Chetlen A, Niell BL, Brown A, Baskies AM, Battaglia T, Chen A, Jochelson MS, Klein KA, Malak SF, Mehta TS, Sinha I, Tuscano DS, Ulaner GA, Slanetz PJ. ACR Appropriateness Criteria® Breast Implant Evaluation: 2023 Update. J Am Coll Radiol 2023; 20:S329-S350. [PMID: 38040459 DOI: 10.1016/j.jacr.2023.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 08/22/2023] [Indexed: 12/03/2023]
Abstract
This document discusses the appropriate initial imaging in both asymptomatic and symptomatic patients with breast implants. For asymptomatic patients with saline implants, no imaging is recommended. If concern for rupture exists, ultrasound is usually appropriate though saline rupture is often clinically evident. The FDA recently recommended patients have an initial ultrasound or MRI examination 5 to 6 years after initial silicone implant surgery and then every 2 to 3 years thereafter. In a patient with unexplained axillary adenopathy with current or prior silicone breast implants, ultrasound and/or mammography are usually appropriate, depending on age. In a patient with concern for silicone implant rupture, ultrasound or MRI without contrast is usually appropriate. In the setting of a patient with breast implants and possible implant-associated anaplastic large cell lymphoma, ultrasound is usually appropriate as the initial imaging. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
Collapse
Affiliation(s)
- Alison Chetlen
- Penn State Health Hershey Medical Center, Hershey, Pennsylvania.
| | - Bethany L Niell
- Panel Chair, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Ann Brown
- Panel Vice-Chair, University of Cincinnati, Cincinnati, Ohio
| | - Arnold M Baskies
- Virtua Willingboro Hospital, Willingboro, New Jersey; American College of Surgeons
| | - Tracy Battaglia
- Boston University Schools of Medicine and Public Health, Boston, Massachusetts, Primary care physician
| | - Andrew Chen
- University of Connecticut School of Medicine, Farmington, Connecticut; American Society of Plastic Surgeons
| | | | | | | | - Tejas S Mehta
- UMass Memorial Medical Center/UMass Chan Medical School, Worcester, Massachusetts
| | - Indranil Sinha
- Harvard Medical School, Boston, Massachusetts; American Geriatrics Society
| | | | - Gary A Ulaner
- Hoag Family Cancer Institute, Newport Beach, California, and University of Southern California, Los Angeles, California; Commission on Nuclear Medicine and Molecular Imaging
| | - Priscilla J Slanetz
- Specialty Chair, Boston University School of Medicine, Boston, Massachusetts
| |
Collapse
|
13
|
Kressin NR, Wormwood JB, Battaglia TA, Slanetz PJ, Gunn CM. Sociodemographic Variations in Women's Reports of Discussions With Clinicians About Breast Density. JAMA Netw Open 2023; 6:e2344850. [PMID: 38010653 PMCID: PMC10682834 DOI: 10.1001/jamanetworkopen.2023.44850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/14/2023] [Indexed: 11/29/2023] Open
Abstract
Importance Breast density notifications advise women to discuss breast density with their clinicians, yet little is known about such discussions. Objectives To examine the content of women's reports of breast density discussions with clinicians and identify variations by women's sociodemographic characteristics (age, income, state legislation status, race and ethnicity, and literacy level). Design, Setting, and Participants This US nationwide, population-based, random-digit dial telephone survey study was conducted from July 1, 2019, to April 30, 2020, among 2306 women aged 40 to 76 years with no history of breast cancer who underwent mammography in the prior 2 years and had heard the term dense breasts or breast density. Results were analyzed from a subsample of 770 women reporting a conversation about breast density with their clinician after their last mammographic screening. Statistical analysis was conducted in April and July 2023. Main Outcomes and Measures Survey questions inquired whether women's clinicians had asked about breast cancer risk or their worries or concerns about breast density, had discussed mammography results or other options for breast cancer screening or their future risk of breast cancer, as well as the extent to which the clinician answered questions about breast density. Results Of the 770 women (358 [47%] aged 50-64 years; 47 Asian [6%], 125 Hispanic [16%], 204 non-Hispanic Black [27%], 317 non-Hispanic White [41%], and 77 other race and ethnicity [10%]) whose results were analyzed, most reported that their clinicians asked questions about breast cancer risk (88% [670 of 766]), discussed mammography results (94% [724 of 768]), and answered patient questions about breast density (81% [614 of 761]); fewer women reported that clinicians had asked about worries or concerns about breast density (69% [524 of 764]), future risk of breast cancer (64% [489 of 764]), or other options for breast cancer screening (61% [459 of 756]). Women's reports of conversations varied significantly by race and ethnicity; non-Hispanic Black women reported being asked questions about breast cancer risk more often than non-Hispanic White women (odds ratio [OR], 2.08 [95% CI, 1.05-4.10]; P = .04). Asian women less often reported being asked about their worries or concerns (OR, 0.42 [95% CI, 0.20-0.86]; P = .02), and Hispanic and Asian women less often reported having their questions about breast density answered completely or mostly (Asian: OR, 0.28 [95% CI, 0.13-0.62]; P = .002; Hispanic: OR, 0.48 [95% CI, 0.27-0.87]; P = .02). Women with low literacy were less likely than women with high literacy to report being asked about worries or concerns about breast density (OR, 0.64 [95% CI, 0.43-0.96]; P = .03), that mammography results were discussed with them (OR, 0.32 [95% CI, 0.16-0.63]; P = .001), or that their questions about breast density were answered completely or mostly (OR, 0.51 [95% CI, 0.32-0.81]; P = .004). Conclusions and Relevance In this survey study, although most women reported that their clinicians counselled them about breast density, the unaddressed worries or concerns and unanswered questions, especially among Hispanic and Asian women and those with low literacy, highlighted areas where discussions could be improved.
Collapse
Affiliation(s)
- Nancy R. Kressin
- Section of General Internal Medicine, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | | | - Tracy A. Battaglia
- Section of General Internal Medicine, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Priscilla J. Slanetz
- Department of Radiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Christine M. Gunn
- Section of General Internal Medicine, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
- Dartmouth Cancer Center, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
| |
Collapse
|
14
|
Catanzano T, Verma N, Sarkany D, Mohammed TL, Slanetz PJ. Developing a Late-Career Roadmap to Continued Career Engagement. Acad Radiol 2023; 30:2757-2760. [PMID: 37758585 DOI: 10.1016/j.acra.2023.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/13/2023] [Accepted: 04/13/2023] [Indexed: 09/29/2023]
Abstract
Professional development needs span the entirety of a radiologist's career. Great strides have been made in the creation of an infrastructure for early career development. Work is ongoing to develop such resources for mid-career radiologists, given the recent recognition of the needs of this group. Unfortunately, even less attention has been paid to late-career radiologist development needs as a bridge to retirement. As part of the Career Conversations series, this article will highlight the needs and currently available resources for this group.
Collapse
Affiliation(s)
- Tara Catanzano
- Department of Radiology, University of Massachusetts Chan Medical School-Baystate, Springfield, MA 01199.
| | - Nupur Verma
- Department of Radiology, University of Florida, Gainesville, FL 32610.
| | - David Sarkany
- Department of Radiology, Zucker School of Medicine at Hofstra/Northwell, Staten Island, NY 10305.
| | | | - Priscilla J Slanetz
- Department of Radiology, Boston University Medical Center, Boston, MA 02118.
| |
Collapse
|
15
|
Hecht EM, Robbins JB, Desser TS, Grist TM, Min RJ, Catanzano TM, Slanetz PJ. Defining the Roles and Responsibilities for the Vice Chair for Academic Affairs/Faculty Development in Radiology. Acad Radiol 2023; 30:2728-2733. [PMID: 37059613 DOI: 10.1016/j.acra.2023.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 04/16/2023]
Abstract
RATIONALE AND OBJECTIVES To inform the development of a job description for Vice-Chairs for academic affairs (VCAA), members of the Alliance of Leaders in Academic Affairs in Radiology (ALAAR) were surveyed to better understand their current job responsibilities and how they would ideally allocate their professional time. MATERIALS AND METHODS Based on a survey of 33 university-affiliated radiology departments and discussion among ALAAR members, the authors developed a detailed job description for the VCAA. The 21-question survey was composed and validated by experts in the field. It was distributed to all members of ALAAR via email with an electronic link and was open for 5 months. Results of the survey were tabulated, and a job description was crafted to represent the foundational roles of academic affairs leaders in radiology. RESULTS The response rate for institutions represented in ALAAR was 73% (33/45). All participants reported that they practiced in a university-affiliated institution. Faculty size varied from ≤49 (30.3%, 10/33), 50-99 faculty (24.2%, 8/33), and ≥100 faculty members (45.5%, 15/33). Only 24% of survey respondents had a detailed job description at the time of hire. More than 40% attested to significant oversight over faculty development programs (45%), mentorship programs (42%, and promotions (45%). Respondents ideally want increased oversight (defined as >10%) over exit interviews, faculty awards, promotions, onboarding, recruitment and hiring, and wellness programming. CONCLUSION The aspirational mission of the VCAA is to oversee components of sequential stages in the professional lifecycle of faculty members but a common job description for this role is lacking.
Collapse
Affiliation(s)
- Elizabeth M Hecht
- Department of Radiology, Weill Cornell Medicine, New York, New York.
| | - Jessica B Robbins
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Terry S Desser
- Department of Radiology, Stanford University School of Medicine, Stanford, California
| | - Thomas M Grist
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Robert J Min
- Department of Radiology, Weill Cornell Medicine, New York, New York
| | - Tara M Catanzano
- Department of Radiology, UMass Chan Medical School-Baystate, Springfield, Massachusetts
| | - Priscilla J Slanetz
- Department of Radiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| |
Collapse
|
16
|
Slanetz PJ, Almeky S, Narayan AK, Bello JA. Pursuing Imaging Equity-Overcoming Barriers, Finding Opportunities. J Am Coll Radiol 2023; 20:1075-1077. [PMID: 37619799 DOI: 10.1016/j.jacr.2023.06.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/06/2023] [Accepted: 06/14/2023] [Indexed: 08/26/2023]
Affiliation(s)
- Priscilla J Slanetz
- Vice Chair of Academic Affairs, Department of Radiology, and Associate Program Director of the Diagnostic Radiology Residency, Department of Radiology, Boston University Medical Center, Boston, Massachusetts, and is also from the Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts; Director of Early Career Faculty Development and Academic Writing Programs for Boston University Medical Group; Past President of Massachusetts Radiological Society; President of the Association of University Radiologists; and Subspecialty Chair of the ACR Appropriateness Criteria Breast Imaging Panels.
| | - Somiah Almeky
- Department of Radiology, Boston University Medical Center, Boston, Massachusetts, and Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts; Vice President of the Massachusetts Radiological Society; Resident, Fellow Section; President-Elect for the next academic year; Radiology Advocacy Network Leader; member Medical Student and Resident teaching committee; and Diversity Equity and Inclusion Council Fellow at Boston Medical Center
| | - Anand K Narayan
- Vice Chair of Equity, Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin; Associate Director of the University of Wisconsin Carbone Cancer Center for Diversity, Equity, and Inclusion; Vice Chair of the ACR's Patient- and Family-Centered Care Outreach Committee; and Director at Large of the Wisconsin Radiological Society
| | - Jacqueline A Bello
- Director of Neuroradiology, Department of Radiology, Montefiore Medical Center, Bronx, New York; Zimmer-Hardy Professor of Neuroradiology, Department of Radiology, Albert Einstein College of Medicine; Chair, ACR Board of Chancellors; and a Past President of the New York Radiological Society, the New York Roentgen Society, and the American Society of Neuroradiology
| |
Collapse
|
17
|
Wells VA, Medeiros I, Shevtsov A, Fishman MDC, Selland DLG, Dao K, Rives AF, Slanetz PJ. Demystifying Breast Disease Markers. Radiographics 2023; 43:e220151. [PMID: 37676826 DOI: 10.1148/rg.220151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
Breast imaging radiologists regularly perform image-guided biopsies of suspicious breast lesions based on features that are associated with a likelihood of malignancy ranging from 2% to greater than 95% (Breast Imaging Reporting and Data System categories 4 and 5). As diagnostic partners, pathologists perform histopathologic assessment of these tissue samples to confirm a diagnosis. Correlating the imaging findings with the histopathologic results is an integral aspect of multidisciplinary breast care. Assessment of radiologic-pathologic concordance is vital in guiding appropriate management, as it enables identification of discordant results, minimizing the chance of misdiagnosis. Undersampling can lead to false-negative results, with the frequencies of false-negative diagnoses varying on the basis of multiple factors, including biopsy type (eg, core needle, vacuum-assisted needle), needle gauge, and type of lesion sampled at biopsy (ie, mass, calcifications, asymmetry, architectural distortion). Improving a radiologist's knowledge of macroscopic and microscopic breast anatomy and more common breast diseases and their expected imaging findings ensures more accurate radiologic-pathologic correlation and management recommendations. The histopathologic and molecular characteristics of biopsy-sampled breast lesions aid in making an accurate diagnosis. Hematoxylin-eosin staining provides critical morphologic details, whereas immunohistochemical staining enables molecular characterization of many benign and malignant lesions, which is critical for tailored treatment. The authors review commonly encountered benign and malignant breast diseases, their corresponding histopathologic phenotypes, and the histopathologic markers that are essential to clinching the diagnosis of these entities. As part of a multidisciplinary team that provides optimal patient care, radiologists should be knowledgeable of the foundations of histopathologic diagnosis and the implications for patient management to ensure appropriate radiologic-pathologic concordance. ©RSNA, 2023 Quiz questions for this article are available in the supplemental material.
Collapse
Affiliation(s)
- Victoria A Wells
- From the Departments of Radiology (V.A.W., M.D.C.F., D.L.G.S., K.D., A.F.R., P.J.S.) and Pathology (I.M., A.S.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, 820 Harrison Ave, FGH Building, 4th Floor, Boston, MA 02118
| | - Isabela Medeiros
- From the Departments of Radiology (V.A.W., M.D.C.F., D.L.G.S., K.D., A.F.R., P.J.S.) and Pathology (I.M., A.S.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, 820 Harrison Ave, FGH Building, 4th Floor, Boston, MA 02118
| | - Artem Shevtsov
- From the Departments of Radiology (V.A.W., M.D.C.F., D.L.G.S., K.D., A.F.R., P.J.S.) and Pathology (I.M., A.S.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, 820 Harrison Ave, FGH Building, 4th Floor, Boston, MA 02118
| | - Michael D C Fishman
- From the Departments of Radiology (V.A.W., M.D.C.F., D.L.G.S., K.D., A.F.R., P.J.S.) and Pathology (I.M., A.S.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, 820 Harrison Ave, FGH Building, 4th Floor, Boston, MA 02118
| | - Donna-Lee G Selland
- From the Departments of Radiology (V.A.W., M.D.C.F., D.L.G.S., K.D., A.F.R., P.J.S.) and Pathology (I.M., A.S.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, 820 Harrison Ave, FGH Building, 4th Floor, Boston, MA 02118
| | - Kevin Dao
- From the Departments of Radiology (V.A.W., M.D.C.F., D.L.G.S., K.D., A.F.R., P.J.S.) and Pathology (I.M., A.S.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, 820 Harrison Ave, FGH Building, 4th Floor, Boston, MA 02118
| | - Anna F Rives
- From the Departments of Radiology (V.A.W., M.D.C.F., D.L.G.S., K.D., A.F.R., P.J.S.) and Pathology (I.M., A.S.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, 820 Harrison Ave, FGH Building, 4th Floor, Boston, MA 02118
| | - Priscilla J Slanetz
- From the Departments of Radiology (V.A.W., M.D.C.F., D.L.G.S., K.D., A.F.R., P.J.S.) and Pathology (I.M., A.S.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, 820 Harrison Ave, FGH Building, 4th Floor, Boston, MA 02118
| |
Collapse
|
18
|
DeBenedectis CM, Lewis MC, Cooke EA, Menash SJ, Robbins JB, Slanetz PJ, Deitte L. Operationalizing the New ABR Residency Leave Policy for Trainees: A Practical Guide for Program Directors. Acad Radiol 2023; 30:1709-1713. [PMID: 36473796 DOI: 10.1016/j.acra.2022.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/04/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022]
Affiliation(s)
| | - Madeline C Lewis
- Department of Radiology, Medical University of South Carolina, Charleston, South Carolina
| | - Erin A Cooke
- Director of Arts, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Sarah J Menash
- Seattle Children's Hospital and University of Washington School of Medicine, Seattle, Washington
| | - Jessica B Robbins
- Vice Chair of Faculty Development and Enrichment, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Priscilla J Slanetz
- Division of Breast Imaging, Department of Radiology, Boston University Medical Center and Boston University School of Medicine, Boston, Massachusetts
| | - Lori Deitte
- Department of Radiology and Radiological Sciences, Continuous Professional Development, Vanderbilt University Medical Center, Nashville, Tennessee
| |
Collapse
|
19
|
Poynton CB, Slanetz PJ. The Potential for Personalized Screening Using Image-based AI Risk Assessment. Radiology 2023; 308:e231849. [PMID: 37642570 DOI: 10.1148/radiol.231849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Affiliation(s)
- Clare B Poynton
- From the Department of Radiology, Boston University Medical Center, 830 Harrison Ave, Boston, MA 02118
| | - Priscilla J Slanetz
- From the Department of Radiology, Boston University Medical Center, 830 Harrison Ave, Boston, MA 02118
| |
Collapse
|
20
|
DiPrete O, Wei CJ, Phillips J, Fishman MDC, Slanetz PJ, Lotfi P, Brook A, Dialani V. Management of Mammographic Architectural Distortion Based on Contrast-enhanced MRI and US Correlation. J Breast Imaging 2023; 5:425-435. [PMID: 38416901 DOI: 10.1093/jbi/wbad032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Indexed: 03/01/2024]
Abstract
OBJECTIVE The objective was to evaluate outcomes of mammographic architectural distortion (AD) with and without MRI and US correlates. METHODS A retrospective review of unexplained mammographic AD with subsequent MRI from January 1, 2007 to September 30, 2017 was performed using a reader-based study design. Mammographic, MRI, and US features and outcomes were documented. Truth was based on biopsy results or minimum two-year imaging follow-up. Measures of diagnostic accuracy were calculated. RESULTS Fifty-six cases of AD were included: 29 (51.8%) detected on 2D mammogram and 27 (48.2%) detected on digital breast tomosynthesis. Of 35.7% (20/56) with MRI correlate, 40.0% (8/20) were enhancing masses, 55.0% (11/20) were non-mass enhancement (NME), and 5.0% (1/20) were nonenhancing AD. Of eight enhancing masses, 75.0% (6/8) were invasive cancers, and 25.0% (2/8) were high-risk lesions. Of 11 NME, 18.2% (2/11) were ductal carcinoma in situ, 36.4% (4/11) were high-risk lesions, and 45.4% (5/11) were benign. Of 64.3% (36/56) without MRI correlate, 94.4% (34/36) were benign by pathology or follow-up, one (2.8%, 1/36) was a 4-mm focus of invasive cancer with US correlate, and one (1/36, 2.8%) was a high-risk lesion. Of cases without MRI and US correlates, one (3.0%, 1/33) was a high-risk lesion and 97.0% (32/33) were benign. The negative predictive value of mammographic AD without MRI correlate was 97.2% (35/36) and without both MRI and US correlates was 100.0% (33/33). CONCLUSION Mammographic AD without MRI or US correlate was not cancer in our small cohort and follow-up could be considered, reducing interventions.
Collapse
Affiliation(s)
- Olivia DiPrete
- Beth Israel Deaconess Medical Center, Department of Radiology, Boston, MA, USA
| | - Catherine J Wei
- Mass General Brigham - Salem Hospital, Department of Radiology, Salem, MA, USA
| | | | | | | | - Parisa Lotfi
- Danbury Radiological Associates, Department of Radiology, Danbury, CT, USA
| | - Alexander Brook
- Beth Israel Deaconess Medical Center, Department of Radiology, Boston, MA, USA
| | - Vandana Dialani
- Beth Israel Deaconess Medical Center, Department of Radiology, Boston, MA, USA
| |
Collapse
|
21
|
Brown T, Schafer L, Qureshi MM, Freer P, Niell BL, Yeh ED, Moy L, Fishman MDC, Slanetz PJ. Current Practices in Anticoagulation Management for Patients Undergoing Percutaneous Image-guided Breast Procedures. J Breast Imaging 2023; 5:445-452. [PMID: 37520156 PMCID: PMC10380696 DOI: 10.1093/jbi/wbad040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Indexed: 08/01/2023]
Abstract
Objective Given variability in how practices manage patients on antithrombotic medications, we undertook this study to understand the current practice of antithrombotic management for patients undergoing percutaneous breast and axillary procedures. Methods A 20-item survey with multiple-choice and write-in options was emailed to 2094 active North American members of the Society of Breast Imaging (SBI) in March 2021. Data were collected anonymously and analyzed quantitatively, with free-text responses categorized by themes. Results Three-hundred twenty-six of 2094 members (15.6%) completed the survey. Eighty-seven percent (274/313) reported having a policy for managing antithrombotic medications. Fifty-nine percent (185/312) reported routinely withholding medications before biopsy, more commonly in the Northeast and South (P = 0.08). Withholding of medications did not vary by lesion location (182/308, 59%, breast vs 181/308, 58.7%, axillary; P = 0.81). Respondents were statistically more likely to withhold medications if using a vacuum-assisted device for all classes of antithrombotic medications (P < 0.001). Up to 50.2% (100/199) on warfarin and 33.6% (66/196) on direct oral anticoagulants had medications withheld more stringently than guidelines suggest. Conclusion Based on a survey of SBI members, breast imaging practices vary widely in antithrombotic management for image-guided breast and axillary procedures. Of the 60% who withhold antithrombotic medications, a minority comply with recommended withhold guidelines, placing at least some patients at potential risk for thrombotic events. Breast imaging radiologists should weigh the risks and benefits of withholding these medications, and if they elect to withhold should closely follow evidence-based guidelines to minimize the risks of this practice.
Collapse
Affiliation(s)
- Theodore Brown
- Boston University Medical Center, Department of Radiology, Boston, MA, USA
| | - Leah Schafer
- New Zealand Pacific Radiology Group, Wellington, New Zealand
| | | | - Phoebe Freer
- University of Utah, Department of Radiology, Salt Lake City, UT, USA
| | - Bethany L Niell
- H. Lee Moffitt Cancer Center and Research Institute, Department of Oncologic Sciences, Tampa, FL, USA
| | - Eren D Yeh
- Brigham and Women’s Hospital, Department of Radiology, Boston, MA, USA
| | - Linda Moy
- NYU Grossman School of Medicine, Laura and Isaac Perlmutter Cancer Center, New York, NY, USA
| | | | | |
Collapse
|
22
|
DeBenedectis CM, Spalluto LB, Americo L, Bishop C, Mian A, Sarkany D, Kagetsu NJ, Slanetz PJ. APDR Healthcare Disparities Curriculum Pilot: Helping Trainees Meet More Than a Milestone. Acad Radiol 2023; 30:1173-1180. [PMID: 37197840 DOI: 10.1016/j.acra.2022.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/14/2022] [Accepted: 07/14/2022] [Indexed: 05/19/2023]
Abstract
RATIONALE AND OBJECTIVES In order to help program directors satisfy the Accreditation Council for Graduate Medical Education common program requirement for health care disparities (HCD) education, a comprehensive web-based curriculum on HCDs in Radiology was developed. The curriculum was designed to educate trainees about existing HCDs, stimulate discussion, and spur research about HCDs in radiology. The curriculum was piloted to assess its educational value and feasibility. MATERIAL AND METHODS A comprehensive curriculum comprised of four modules (1) Introduction to HCDs in Radiology, (2) Types of HCDs in Radiology, (3) Actions to Address HCDs in Radiology, and (4) Cultural Competency was created and housed on the Associate of Program Directors in Radiology website. Various educational media including recorded lectures or PowerPoint presentations, small group discussions, and journal clubs were employed. A pilot program was initiated to evaluate the benefits of this curriculum for resident education and consisted of a pre- and post-curriculum test for trainees, an experience survey for trainees, and a pre- and post-administration survey for facilitators. RESULTS Forty-seven radiology residency programs participated in the pilot of the HCD curriculum. Of those facilitating the curriculum, 83% indicated lack of standardized curriculum as a perceived barrier to implementing a HCD curriculum at their program on the pre-survey. Trainee knowledge scores increased from 65% (pre) to 67% (post) (p = 0.05). Following curriculum participation, residents indicated an increase in adequate understanding of HCDs in Radiology (81% post vs. 45% pre). Most program directors (75%) found the curriculum easy to implement. CONCLUSION This pilot study demonstrated that the APDR Health Care Disparities curriculum increased trainee awareness of HCDs. The curriculum also provided a forum for important discussions about HCDs.
Collapse
Affiliation(s)
| | - Lucy B Spalluto
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee; Vanderbilt Ingram Cancer Center, Nashville, Tennessee; Veterans Health Administration - Tennessee Valley Healthcare System Geriatric Research, Education and Clinical Center (GRECC), Nashville, Tennessee
| | - Lisa Americo
- Department of Radiology, Weill Cornell Medicine, New York, New York
| | - Casey Bishop
- Department of Radiology, Boston University Medical Center and Boston University School of Medicine, Boston, Massachusetts
| | - Asim Mian
- Department of Radiology, Boston University Medical Center and Boston University School of Medicine, Boston, Massachusetts
| | - David Sarkany
- Department of Radiology, Weill Cornell Medicine, New York, New York
| | - Nolan J Kagetsu
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Priscilla J Slanetz
- Department of Radiology, Boston University Medical Center and Boston University School of Medicine, Boston, Massachusetts
| |
Collapse
|
23
|
Affiliation(s)
- Ana P Lourenco
- From the Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University and Rhode Island Hospital, 593 Eddy St, 3rd Floor, Providence, RI 02903 (A.P.L., G.L.B.); and Department of Radiology, Boston University Medical Center, Boston, Mass (P.J.S.)
| | - Priscilla J Slanetz
- From the Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University and Rhode Island Hospital, 593 Eddy St, 3rd Floor, Providence, RI 02903 (A.P.L., G.L.B.); and Department of Radiology, Boston University Medical Center, Boston, Mass (P.J.S.)
| | - Grayson L Baird
- From the Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University and Rhode Island Hospital, 593 Eddy St, 3rd Floor, Providence, RI 02903 (A.P.L., G.L.B.); and Department of Radiology, Boston University Medical Center, Boston, Mass (P.J.S.)
| |
Collapse
|
24
|
Slanetz PJ. The Promise of AI in Advancing Global Radiology. Radiology 2023; 307:e230895. [PMID: 37129489 DOI: 10.1148/radiol.230895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Affiliation(s)
- Priscilla J Slanetz
- From the Division of Breast Imaging, Department of Radiology, FGH-4, Boston Medical Center, 820 Harrison Ave, Boston, MA 02118; and Boston University Chobanian & Avedisian School of Medicine, Boston, Mass
| |
Collapse
|
25
|
Siewert B, Bruno MA, Fleishon HB, Hublall R, Slanetz PJ, Jankovic SN, Kotsenas AL, Schwartz ES, Pawley B, Mukherji SK, Bourland JD, Artunduaga M, Saif M, Poussaint TY, Scanlon MH, Kirsch J, Lexa FJ. Summary of the 2022 ACR Intersociety Meeting. J Am Coll Radiol 2023; 20:479-486. [PMID: 37121627 DOI: 10.1016/j.jacr.2023.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 03/06/2023] [Indexed: 05/02/2023]
Abstract
The ACR Intersociety Committee meeting of 2022 (ISC-2022) was convened around the theme of "Recovering From The Great Resignation, Moral Injury and Other Stressors: Rebuilding Radiology for a Robust Future." Representatives from 29 radiology organizations, including all radiology subspecialties, radiation oncology, and medical physics, as well as academic and private practice radiologists, met for 3 days in early August in Park City, Utah, to search for solutions to the most pressing problems facing the specialty of radiology in 2022. Of these, the mismatch between the clinical workload and the available radiologist workforce was foremost-as many other identifiable problems flowed downstream from this, including high job turnover, lack of time for teaching and research, radiologist burnout, and moral injury.
Collapse
Affiliation(s)
- Bettina Siewert
- Associate Professor of Radiology, Harvard Medical School, Boston, Massachusetts, and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Vice Chair of RSNA Quality Improvement Committee.
| | - Michael A Bruno
- Professor of Radiology and Professor of Medicine, Penn State University, University Park, Pennsylvania, and Department of Radiology, Penn State Health, Hershey Medical Center, Hershey, Pennsylvania
| | - Howard B Fleishon
- Associate Professor of Radiology, Department of Radiology and Imaging Sciences, Atlanta, Georgia; President, ACR
| | - Ronald Hublall
- Central Illinois Radiological Associates, East Peoria, Illinois
| | - Priscilla J Slanetz
- Professor of Radiology, Boston University Chobanian & Avedisian School of Medicine and Department of Radiology, Boston Medical Center, Boston, Massachusetts; President-Elect, AUR; Vice Chair of Academic Affairs in the Department of Radiology and Associate Program Director of the Diagnostic Radiology Residency, Boston Medical Center; Subspecialty Chair, ACR Appropriateness Criteria Breast Imaging Panels; Chair, Mentorship Committee, Society of Breast Imaging; Co-Chair, Fellowship Committee and Breast Imaging Committee of the Massachusetts Radiological Society
| | - Stephanie N Jankovic
- Department of Radiology, Oregon Health & Science University Hospital, Portland, Oregon
| | - Amy L Kotsenas
- Professor of Radiology, Mayo Clinic School of Medicine, Rochester, Minnesota, and Department of Radiology, Mayo Clinic, Rochester, Minnesota; Board of Chancellors, ACR
| | - Erin S Schwartz
- Professor of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania and Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Barbara Pawley
- Associate Professor of Radiology, University of Kentucky, Lexington, Kentucky, and Department of Radiology, UK Albert B. Chandler Hospital, Lexington, Kentucky; Immediate Past-President, American Association for Women Radiologists
| | | | - J Daniel Bourland
- Professor of Radiation Oncology, Department of Radiation Oncology, Wake Forest University School of Medicine, Winston-Salem, North Carolina; 2022 President, American Association of Physicists in Medicine, 2023 Chair, Board of Directors, American Association of Physicists in Medicine
| | - Maddy Artunduaga
- Assistant Professor of Radiology, Department of Radiology, Pediatric Radiology Division, UT Southwestern Medical Center, Dallas, Texas
| | - Manal Saif
- Department of Radiology, Penn State Health, Hershey Medical Center, Hershey, Pennsylvania
| | - Tina Y Poussaint
- Lionel W. Young Chair in Radiology, Professor of Radiology, Harvard Medical School, Boston, Massachusetts, and Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, 1st Past President, American Society of Neyruradiology
| | - Mary H Scanlon
- Clinical Professor of Radiology, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, Pennsylvania, and Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, President, Association of Program Directors in Radiology
| | - Jacobo Kirsch
- Chair, Florida Region Imaging Institute, Cleveland Clinic Florida, Weston Hospital, Weston, Florida
| | - Frank J Lexa
- Professor and Vice Chair Faculty Affairs, Department of Radiology, University of Pittsburgh Medical Center International, Pittsburgh, Pennsylvania; Vice President, ACR; Chief Medical Officer, The Radiology Leadership Institute of the ACR
| |
Collapse
|
26
|
Hayward JH, Linden OE, Lewin AA, Weinstein SP, Bachorik AE, Balija TM, Kuzmiak CM, Paulis LV, Salkowski LR, Sanford MF, Scheel JR, Sharpe RE, Small W, Ulaner GA, Slanetz PJ. ACR Appropriateness Criteria® Monitoring Response to Neoadjuvant Systemic Therapy for Breast Cancer: 2022 Update. J Am Coll Radiol 2023; 20:S125-S145. [PMID: 37236739 DOI: 10.1016/j.jacr.2023.02.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 02/27/2023] [Indexed: 05/28/2023]
Abstract
Imaging plays a vital role in managing patients undergoing neoadjuvant chemotherapy, as treatment decisions rely heavily on accurate assessment of response to therapy. This document provides evidence-based guidelines for imaging breast cancer before, during, and after initiation of neoadjuvant chemotherapy. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
Collapse
Affiliation(s)
| | - Olivia E Linden
- Research Author, University of California, San Francisco, San Francisco, California
| | - Alana A Lewin
- Panel Chair, New York University Grossman School of Medicine, New York, New York
| | - Susan P Weinstein
- Panel Vice-Chair, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Tara M Balija
- Hackensack University Medical Center, Hackensack, New Jersey; American College of Surgeons
| | - Cherie M Kuzmiak
- University of North Carolina Hospital, Chapel Hill, North Carolina
| | | | - Lonie R Salkowski
- University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin
| | | | | | | | - William Small
- Loyola University Chicago, Stritch School of Medicine, Department of Radiation Oncology, Cardinal Bernardin Cancer Center, Maywood, Illinois
| | - Gary A Ulaner
- Hoag Family Cancer Institute, Newport Beach, California, and University of Southern California, Los Angeles, California; Commission on Nuclear Medicine and Molecular Imaging
| | - Priscilla J Slanetz
- Specialty Chair, Boston University School of Medicine, Boston, Massachusetts
| |
Collapse
|
27
|
Kressin NR, Wormwood JB, Battaglia TA, Slanetz PJ, Gunn CM. Women's Reactions to Breast Density Information Vary by Sociodemographic Characteristics. Womens Health Issues 2023:S1049-3867(23)00070-1. [PMID: 37087312 DOI: 10.1016/j.whi.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 02/27/2023] [Accepted: 03/07/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND Breast density information aims to increase awareness of breast density and its risks and to foster more informed future breast screening decisions among women with dense breasts. We explored associations between such information and outcomes including anxiety, confusion, or feeling informed, and whether they varied by race/ethnicity or literacy, or differentially affected future mammography plans. METHODS A national telephone survey of a diverse sample of women previously informed of personal breast density (N = 1,322) assessed reactions to receipt of breast density information and future mammography plans. RESULTS Most women (86%) felt informed after receiving personal breast density information; however, some felt anxious (15%) or confused (11%). Reactions varied significantly by sociodemographics; non-Hispanic Black, Asian, and Hispanic women and women with low literacy were nearly two to three times more likely to report anxiety than non-Hispanic White women (all ps < .05). Asian women and those with low literacy less often felt informed and more often felt confused. Non-Hispanic Black and Asian women were nearly twice as likely to report that knowing their breast density made them more likely to have future mammograms. Women with low literacy were more likely to change mammography plans, with some being more likely and others less likely to plan to have future mammograms. Greater anxiety and confusion were associated with higher likelihood of planning future mammograms; those feeling informed were less likely to plan future mammography. CONCLUSIONS Differential reactions to breast density information are concerning if associated with disparate future screening plans. Future breast density education efforts should ensure that such information is readily accessible and understandable to all women in order to lead to desired effects.
Collapse
Affiliation(s)
- Nancy R Kressin
- Section of General Internal Medicine, Department of Medicine, Boston University Chobanian and Avedesian School of Medicine, Boston, Massachusetts.
| | - Jolie B Wormwood
- Department of Psychology, University of New Hampshire, Durham, New Hampshire
| | - Tracy A Battaglia
- Section of General Internal Medicine, Department of Medicine, Boston University Chobanian and Avedesian School of Medicine, Boston, Massachusetts
| | - Priscilla J Slanetz
- Department of Radiology, Boston University Chobanian and Avedesian School of Medicine, Boston, Massachusetts
| | - Christine M Gunn
- Section of General Internal Medicine, Department of Medicine, Boston University Chobanian and Avedesian School of Medicine, Boston, Massachusetts; The Dartmouth Institute for Health Policy and Clinical Practice and Dartmouth Cancer Center, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
| |
Collapse
|
28
|
Ngo M, Qureshi M, Kim G, Fishman MDC, Slanetz PJ. Effect of a High-Deductible Health Plan on Patients' Willingness to Undergo Indicated Breast Imaging. Radiology 2023; 307:e222952. [PMID: 37014241 DOI: 10.1148/radiol.222952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Affiliation(s)
- Michael Ngo
- From the Departments of Radiology (M.N., M.D.C.F., P.J.S.) and Radiation Oncology (M.Q.), Chobanian and Avedisian School of Medicine, 820 Harrison Ave, FGH-3001, Boston, MA 02118; and Department of Radiology, Atrius Health, Newton, Mass (G.K.)
| | - Muhammad Qureshi
- From the Departments of Radiology (M.N., M.D.C.F., P.J.S.) and Radiation Oncology (M.Q.), Chobanian and Avedisian School of Medicine, 820 Harrison Ave, FGH-3001, Boston, MA 02118; and Department of Radiology, Atrius Health, Newton, Mass (G.K.)
| | - Geunwon Kim
- From the Departments of Radiology (M.N., M.D.C.F., P.J.S.) and Radiation Oncology (M.Q.), Chobanian and Avedisian School of Medicine, 820 Harrison Ave, FGH-3001, Boston, MA 02118; and Department of Radiology, Atrius Health, Newton, Mass (G.K.)
| | - Michael D C Fishman
- From the Departments of Radiology (M.N., M.D.C.F., P.J.S.) and Radiation Oncology (M.Q.), Chobanian and Avedisian School of Medicine, 820 Harrison Ave, FGH-3001, Boston, MA 02118; and Department of Radiology, Atrius Health, Newton, Mass (G.K.)
| | - Priscilla J Slanetz
- From the Departments of Radiology (M.N., M.D.C.F., P.J.S.) and Radiation Oncology (M.Q.), Chobanian and Avedisian School of Medicine, 820 Harrison Ave, FGH-3001, Boston, MA 02118; and Department of Radiology, Atrius Health, Newton, Mass (G.K.)
| |
Collapse
|
29
|
Affiliation(s)
- Priscilla J Slanetz
- From the Division of Breast Imaging, Department of Radiology, Boston University Medical Center, 820 Harrison Ave, FGH-4, Boston, MA 02118; and Boston University Chobanian & Avedisian School of Medicine, Boston, Mass
| |
Collapse
|
30
|
Slanetz PJ, Schoen JH, Maturen KE, Zigmund B. Green Is Rad: Engaging Radiologists in Building More Sustainable Radiology Practices. J Am Coll Radiol 2023; 20:282-284. [PMID: 35397228 DOI: 10.1016/j.jacr.2022.02.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 02/19/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Priscilla J Slanetz
- Vice Chair, Academic Affairs and Associate Program Director, Diagnostic Radiology Residency, Department of Radiology, Boston University Medical Center, Boston, Massachusetts; Department of Radiology Boston University School of Medicine, Boston, Massachusetts; Director, Early Career Faculty Development and Co-Director of the Academic Writing Program, Boston University Medical Group, Boston, Massachusetts; President of Massachusetts Radiological Society; Vice President, Association of University Radiologists; and Subspecialty Chair, ACR Appropriateness Criteria® Breast Imaging Panels.
| | - Julia H Schoen
- Department of Radiology, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina; and Chair, Radiologists for a Sustainable Future
| | - Katherine E Maturen
- Associate Chair for Ambulatory Care and Strategy, Department of Radiology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan; and Board of Directors for the Society of Abdominal Radiology and the Board of Trustees for the American Board of Radiology
| | - Beth Zigmund
- Director, Lung Cancer Screening and Education Director, Cardiothoracic Imaging, Department of Radiology, University of Vermont Medical Center, Burlington, Vermont; Department of Radiology, Larner College of Medicine at the University of Vermont, Burlington, Vermont; and Leader, Advocacy Team for Radiologists for a Sustainable Future
| |
Collapse
|
31
|
Kressin NR, Slanetz PJ, Gunn CM. Ensuring Clarity and Understandability of the FDA's Breast Density Notifications. JAMA 2023; 329:121-122. [PMID: 36508205 PMCID: PMC10152312 DOI: 10.1001/jama.2022.22753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This Viewpoint discusses the use of breast density notifications to inform women with dense breast tissue of the potential need for supplemental cancer screening, as well as the need to ensure that such notifications are clear and understandable to women of all language backgrounds, literacy levels, educational levels, and socioeconomic backgrounds.
Collapse
Affiliation(s)
- Nancy R Kressin
- Section of General Internal Medicine, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Priscilla J Slanetz
- Department of Radiology, Boston University Aram V. Chobanian & Edward Avedisian School of Medicine, Boston, Massachusetts
| | - Christine M Gunn
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Cancer Center, Dartmouth Geisel School of Medicine, Hanover, New Hampshire
| |
Collapse
|
32
|
Beidler LB, Kressin NR, Wormwood JB, Battaglia TA, Slanetz PJ, Gunn CM. Perceptions of Breast Cancer Risks Among Women Receiving Mammograph Screening. JAMA Netw Open 2023; 6:e2252209. [PMID: 36689223 PMCID: PMC9871800 DOI: 10.1001/jamanetworkopen.2022.52209] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/02/2022] [Indexed: 01/24/2023] Open
Abstract
Importance Breast density is an independent risk factor for breast cancer. Despite the proliferation of mandated written notifications about breast density following mammography, there is little understanding of how women perceive the relative breast cancer risk associated with breast density. Objective To assess women's perception of breast density compared with other breast cancer risks and explore their understanding of risk reduction. Design, Setting, and Participants This mixed-methods qualitative study used telephone surveys and semistructured interviews to investigate perceptions about breast cancer risk among a nationally representative, population-based sample of women. Eligible study participants were aged 40 to 76 years, reported having recently undergone mammography, had no history of prior breast cancer, and had heard of breast density. Survey participants who had been informed of their personal breast density were invited for a qualitative interview. Survey administration spanned July 1, 2019, to April 30, 2020, with 2306 women completing the survey. Qualitative interviews were conducted from February 1 to May 30, 2020. Main Outcomes and Measures Respondents compared the breast cancer risk associated with breast density with 5 other risk factors. Participants qualitatively described what they thought contributed to breast cancer risk and ways to reduce risk. Results Of the 2306 women who completed the survey, 1858 (166 [9%] Asian, 503 [27%] Black, 268 [14%] Hispanic, 792 [43%] White, and 128 [7%] other race or ethnicity; 358 [19%] aged 40-49 years, 906 [49%] aged 50-64 years, and 594 [32%] aged ≥65 years) completed the revised risk perception questions and were included in the analysis. Half of respondents thought breast density to be a greater risk than not having children (957 [52%]), having more than 1 alcoholic drink per day (975 [53%]), or having a prior breast biopsy (867 [48%]). Most respondents felt breast density was a lesser risk than having a first-degree relative with breast cancer (1706 [93%]) or being overweight or obese (1188 [65%]). Of the 61 women who were interviewed, 6 (10%) described breast density as contributing to breast cancer risk, and 43 (70%) emphasized family history as a breast cancer risk factor. Of the interviewed women, 17 (28%) stated they did not know whether it was possible to reduce their breast cancer risk. Conclusions and Relevance In this qualitative study of women of breast cancer screening age, family history was perceived as the primary breast cancer risk factor. Most interviewees did not identify breast density as a risk factor and did not feel confident about actions to mitigate breast cancer risk. Comprehensive education about breast cancer risks and prevention strategies is needed.
Collapse
Affiliation(s)
- Laura B. Beidler
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
| | - Nancy R. Kressin
- Section of General Internal Medicine, Boston University Chobanian and Avedesian School of Medicine, Boston, Massachusetts
| | | | - Tracy A. Battaglia
- Section of General Internal Medicine, Boston University Chobanian and Avedesian School of Medicine, Boston, Massachusetts
| | - Priscilla J. Slanetz
- Department of Radiology, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts
| | - Christine M. Gunn
- Dartmouth Cancer Center, The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
| |
Collapse
|
33
|
Catanzano T, Verma N, Sarkany D, Mohammed TL, Slanetz PJ. What's Next? - Career Conversations - Enlightening Decision Points for Every Career Stage. Acad Radiol 2022; 29:1617-1618. [PMID: 36210275 DOI: 10.1016/j.acra.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 09/09/2022] [Accepted: 09/09/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Tara Catanzano
- Department of Radiology, University of Massachusetts Chan Medical School-Baystate, Springfield, Massachusetts.
| | - Nupur Verma
- Department of Radiology, University of Florida, Gainesville, Florida
| | - David Sarkany
- Department of Radiology, Zucker School of Medicine at Hofstra/Northwell, Staten Island, New York
| | | | - Priscilla J Slanetz
- Academic Affairs, Department of Radiology, Boston University Medical Center, Boston, Massachusetts
| |
Collapse
|
34
|
Catanzano T, Verma N, Sarkany D, Mohammed TL, Slanetz PJ. The Midcareer Syndrome: Reflection and Repositioning for Better Career Engagement. Acad Radiol 2022; 29:1619-1622. [PMID: 36192268 DOI: 10.1016/j.acra.2022.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/09/2022] [Accepted: 09/14/2022] [Indexed: 11/01/2022]
Affiliation(s)
- Tara Catanzano
- Department of Radiology, University of Massachusetts Chan Medical School-Baystate, Springfield, Massachusetts.
| | - Nupur Verma
- Department of Radiology, University of Florida, Gainesville, Florida
| | - David Sarkany
- Department of Radiology, Zucker School of Medicine at Hofstra/Northwell, Staten Island, New York
| | | | - Priscilla J Slanetz
- Department of Radiology, Boston University Medical Center, Boston, Massachusetts
| |
Collapse
|
35
|
Sanford MF, Slanetz PJ, Lewin AA, Baskies AM, Bozzuto L, Branton SA, Hayward JH, Le-Petross HT, Newell MS, Scheel JR, Sharpe RE, Ulaner GA, Weinstein SP, Moy L. ACR Appropriateness Criteria® Evaluation of Nipple Discharge: 2022 Update. J Am Coll Radiol 2022; 19:S304-S318. [PMID: 36436958 DOI: 10.1016/j.jacr.2022.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 09/07/2022] [Indexed: 11/27/2022]
Abstract
The type of nipple discharge dictates the appropriate imaging study. Physiologic nipple discharge is common and does not require diagnostic imaging. Pathologic nipple discharge in women, men, and transgender patients necessitates breast imaging. Evidence-based guidelines were used to evaluate breast imaging modalities for appropriateness based on patient age and gender. For an adult female or male 40 years of age or greater, mammography or digital breast tomosynthesis (DBT) is performed initially. Breast ultrasound is usually performed at the same time with rare exception. For males or females 30 to 39 years of age, mammography/DBT or breast ultrasound is performed based on institutional preference and individual patient considerations. For young women less than 30 years of age, ultrasound is performed first with mammography/DBT added if there are suspicious findings or if the patient is at elevated lifetime risk for developing breast cancer. There is a high incidence of breast cancer in males with pathologic discharge. Men 25 years and older should be evaluated using mammography/DBT and ultrasound added when indicted. In transfeminine (male-to-female) patients, mammography/DBT and ultrasound are useful due to the increased incidence of breast cancer. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer-reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances in which peer-reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
Collapse
Affiliation(s)
- Matthew F Sanford
- Lead Interpreting Physician, Sanford Health of Northern Minnesota, Bemidji, Minnesota.
| | - Priscilla J Slanetz
- Panel Chair, Boston University School of Medicine, Boston, Massachusetts; Vice Chair, Academic Affairs, Department of Radiology, Associate Program Director, BMC Diagnostic Radiology Residency and Program Director, Academic Writing Program Boston Medical Center, Boston, Massachusetts
| | - Alana A Lewin
- Panel Vice-Chair, New York University School of Medicine, New York, New York
| | - Arnold M Baskies
- Virtua Willingboro Hospital, Willingboro, New Jersey; American College of Surgeons; Clinical Professor, Surgery, Rowan School of Medicine, Stratford, New Jersey
| | - Laura Bozzuto
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; American College of Obstetricians and Gynecologists
| | - Susan A Branton
- Medical Directo, Breast Health Center and Medical Staff President, UPMC North Central, Pittsburgh, Pennsylvania; American College of Surgeons
| | | | - Huong T Le-Petross
- Breast MRI Director, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - John R Scheel
- Vice-Chair, Global Health, University of Washington, Seattle, Washington
| | | | - Gary A Ulaner
- James & Pamela Muzzy Endowed Chair, Molecular Imaging and Therapy, Hoag Family Cancer Institute, Newport Beach, California
| | - Susan P Weinstein
- Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania; Associate Chair for Radiology Network Strategic Projects
| | - Linda Moy
- Specialty Chair, NYU Clinical Cancer Center, New York, New York
| |
Collapse
|
36
|
Abstract
When interpreting mammography, breast radiologists may identify radiopaque densities in the axilla on the mediolateral oblique or lateral projections. When such densities are encountered, true calcifications must be differentiated from pseudocalcifications (artifact). Using imaging, breast radiologists should be able to localize the finding as being dermal, within the soft tissues, within a lymph node, or intramuscular. By combining the anatomic location with the clinical presentation and any other imaging findings, breast radiologists will be able to determine the most appropriate management.
Collapse
Affiliation(s)
- Aayushi Rai
- Massachusetts General Hospital, Department of Radiology, Boston, MA, USA
| | - Michael D C Fishman
- Boston University Medical Center, Department of Radiology, Boston, MA and Boston University School of Medicine, Boston, MA, USA
| | - Anna F Rives
- Boston University Medical Center, Department of Radiology, Boston, MA and Boston University School of Medicine, Boston, MA, USA
| | - Priscilla J Slanetz
- Boston University Medical Center, Department of Radiology, Boston, MA and Boston University School of Medicine, Boston, MA, USA
| |
Collapse
|
37
|
Perry H, Narayan A, Phillips J, Sheth MM, Slanetz PJ. Tips for Successful Career Transitions in Breast Imaging. J Breast Imaging 2022; 4:423-429. [PMID: 38416984 DOI: 10.1093/jbi/wbac039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Indexed: 03/01/2024]
Abstract
Whether beginning a new career in breast imaging or switching into a different breast imaging practice for personal or professional advancement, a leadership opportunity, a need to relocate geographically, or simply a better opportunity, it is critical to transition between positions as smoothly as possible. Thoroughly reflecting on your career priorities and goals is essential prior to undertaking any career transition. Once the decision has been made to move to a new position, it is imperative to learn about the dynamics of the new practice and practice environment. Here, we provide suggestions on how to hit the ground running when joining a new breast imaging practice.
Collapse
Affiliation(s)
- Hannah Perry
- University of Vermont Medical Center and Larner College of Medicine at the University of Vermont, Department of Radiology, Burlington, VT, USA
| | - Anand Narayan
- University of Wisconsin-Madison, Department of Radiology, Madison, WI, USA
| | - Jordana Phillips
- Boston University Medical Center and Boston University School of Medicine, Department of Radiology, Boston, MA, USA
| | - Monica M Sheth
- NYU Langone-Long Island Hospital and NYU Grossman School of Medicine, Department of Radiology, Mineola, NY, USA
| | - Priscilla J Slanetz
- Boston University Medical Center and Boston University School of Medicine, Department of Radiology, Boston, MA, USA
| |
Collapse
|
38
|
Catanzano T, Deitte LA, Naeger DM, Morgan DE, Germaine P, Slanetz PJ. Meeting Faculty Development Needs: Review of Current Resources and Opportunities for Program Development. Acad Radiol 2022; 29:1116-1123. [PMID: 34657811 DOI: 10.1016/j.acra.2021.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/11/2021] [Accepted: 08/11/2021] [Indexed: 11/01/2022]
Abstract
This paper will review faculty development focus and programming at the early, mid and late career stages. Topics covered include challenges at each career stage, institutional and national programming currently available for the needs of faculty at that stage, and suggested best practices for development of new career focus and potential programs for each stage.
Collapse
|
39
|
Kressin NR, Wormwood JB, Battaglia TA, Slanetz PJ, Gunn CM. A letter is not enough: Women's preferences for and experiences of receiving breast density information. Patient Educ Couns 2022; 105:2450-2456. [PMID: 35534300 PMCID: PMC9250336 DOI: 10.1016/j.pec.2022.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/11/2022] [Accepted: 03/15/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Despite evidence of disparate uptake of breast density (BD) information, little is known about diverse women's preferences for and experiences learning about BD. METHODS Telephone survey among 2306 racially/ethnically and literacy diverse women; qualitative interviews with 61 survey respondents. Responses by participant race/ethnicity and literacy were examined using bivariate, then multivariable analyses. Interviews were content-analyzed for themes. RESULTS Most women (80%) preferred learning of personal BD from providers, with higher rates among Non-Hispanic Black (85%) than Non-Hispanic White women (80%); and among Non-Hispanic White than Asian women (72%, all ps<0.05). Women with low literacy less often preferred receiving BD information from providers (76% v. 81%), more often preferring written notification (21% vs. 10%); women with high literacy more often preferred learning through an online portal (9% vs 3%). Most women (93%) received BD information from providers (no between group differences). Qualitative findings detailed women's desires for obtaining BD information from providers, written information, and visual depictions of BD. CONCLUSIONS When educating women about BD, one size does not fit all. PRACTICE IMPLICATIONS Additional educational methods are needed beyond written BD notifications to sufficiently address the varying informational needs and preferences of all USA women.
Collapse
Affiliation(s)
- Nancy R Kressin
- Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
| | - Jolie B Wormwood
- Department of Psychology, University of New Hampshire, Durham, NH, USA
| | - Tracy A Battaglia
- Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Priscilla J Slanetz
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA
| | - Christine M Gunn
- Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA; The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
| |
Collapse
|
40
|
Daye D, Achuck E, Slanetz PJ. New England Women in Radiology (NEWR) Invited Lectureship Series: A Novel Program to Advance the Careers of Junior Female Faculty in Academic Radiology. Acad Radiol 2022; 30:919-925. [PMID: 35752573 DOI: 10.1016/j.acra.2022.05.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/18/2022] [Accepted: 05/28/2022] [Indexed: 11/26/2022]
Abstract
RATIONALE AND OBJECTIVES The purpose of this study is to assess the impact of the New England Women in Radiology (NEWR) program, a new program aimed to generate speaking and networking opportunities for junior women radiologists in New England, by providing opportunities to speak at other academic institutions in the region. MATERIALS AND METHODS A total of 12 academic radiology departments and 20 faculty members at various New England institutions participated in the program during its first year. An institutional survey was sent to all participating institutions and a faculty survey was sent to all participating faculty to assess their experience with the program. Experience was measured using a Likert scale. A word cloud was used to visualize common themes in free response survey questions. RESULTS Hundred percent of participating institutions and 67% of participating faculty responded to the corresponding surveys. Hundred percent of responding faculty indicated that they would participate in the program again. Ninety-two percent of faculty said that they would recommend the program to a colleague. Fifty-eight percent found the networking opportunity valuable; while 83% believed that participation in the NEWR program would help them achieve a promotion. Hundred percent of the participating institutions who completed the survey strongly agreed that 1) the program was easy to administer, 2) participating in the program was valuable to their educational mission, and 3) participating in the program benefited the promotion of junior women faculty in their department. CONCLUSION Initial experience with the NEWR program in its first year was positive amongst both faculty and institutional participants. To further help female junior faculty advance their careers in academia, the NEWR program could be adapted to other geographical locations to incorporate a greater number of institutions and faculty.
Collapse
Affiliation(s)
- Dania Daye
- Department of Interventional Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA.
| | - Emily Achuck
- Department of Interventional Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA
| | - Priscilla J Slanetz
- Department of Radiology, Boston University School of Medicine, 72 E Concord Street, Boston, MA
| |
Collapse
|
41
|
Le-Petross HT, Slanetz PJ, Lewin AA, Bao J, Dibble EH, Golshan M, Hayward JH, Kubicky CD, Leitch AM, Newell MS, Prifti C, Sanford MF, Scheel JR, Sharpe RE, Weinstein SP, Moy L. ACR Appropriateness Criteria® Imaging of the Axilla. J Am Coll Radiol 2022; 19:S87-S113. [PMID: 35550807 DOI: 10.1016/j.jacr.2022.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 02/19/2022] [Indexed: 11/26/2022]
Abstract
This publication reviews the current evidence supporting the imaging approach of the axilla in various scenarios with broad differential diagnosis ranging from inflammatory to malignant etiologies. Controversies on the management of axillary adenopathy results in disagreement on the appropriate axillary imaging tests. Ultrasound is often the appropriate initial imaging test in several clinical scenarios. Clinical information (such as age, physical examinations, risk factors) and concurrent complete breast evaluation with mammogram, tomosynthesis, or MRI impact the type of initial imaging test for the axilla. Several impactful clinical trials demonstrated that selected patient's population can received sentinel lymph node biopsy instead of axillary lymph node dissection with similar overall survival, and axillary lymph node dissection is a safe alternative as the nodal staging procedure for clinically node negative patients or even for some node positive patients with limited nodal tumor burden. This approach is not universally accepted, which adversely affect the type of imaging tests considered appropriate for axilla. This document is focused on the initial imaging of the axilla in various scenarios, with the understanding that concurrent or subsequent additional tests may also be performed for the breast. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
Collapse
Affiliation(s)
| | - Huong T Le-Petross
- The University of Texas MD Anderson Cancer Center, Houston, Texas; Director of Breast MRI.
| | - Priscilla J Slanetz
- Panel Chair, Boston University School of Medicine, Boston, Massachusetts; Vice Chair of Academic Affairs, Department of Radiology, Boston Medical Center; Associate Program Director, Diagnostic Radiology Residency, Boston Medical Center; Program Director, Early Career Faculty Development Program, Boston University Medical Campus; Co-Director, Academic Writing Program, Boston University Medical Group; President, Massachusetts Radiological Society; Vice President, Association of University Radiologists
| | - Alana A Lewin
- Panel Vice-Chair, New York University School of Medicine, New York, New York; Associate Program Director, Breast Imaging Fellowship, NYU Langone Medical Center
| | - Jean Bao
- Stanford University Medical Center, Stanford, California; Society of Surgical Oncology
| | | | - Mehra Golshan
- Smilow Cancer Hospital, Yale Cancer Center, New Haven, Connecticut; American College of Surgeons; Deputy CMO for Surgical Services and Breast Program Director, Smilow Cancer Hospital at Yale; Executive Vice Chair for Surgery, Yale School of Medicine
| | - Jessica H Hayward
- University of California San Francisco, San Francisco, California; Co-Fellowship Direction, Breast Imaging Fellowship
| | | | - A Marilyn Leitch
- UT Southwestern Medical Center, Dallas, Texas; American Society of Clinical Oncology
| | - Mary S Newell
- Emory University Hospital, Atlanta, Georgia; Interim Director, Division of Breast Imaging at Emory; ACR: Chair of BI-RADS; Chair of PP/TS
| | - Christine Prifti
- Boston Medical Center, Boston, Massachusetts, Primary care physician
| | | | | | | | - Susan P Weinstein
- Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania; Associate Chief of Radiology, San Francisco VA Health Systems
| | - Linda Moy
- Specialty Chair, NYU Clinical Cancer Center, New York, New York; Chair of ACR Practice Parameter for Breast Imaging, Chair ACR NMD
| |
Collapse
|
42
|
Burns J, Chetlen A, Morgan DE, Catanzano TM, McLoud TC, Slanetz PJ, Jay AK. Affecting Change: Enhancing Feedback Interactions with Radiology Trainees. Acad Radiol 2022; 29 Suppl 5:S111-S117. [PMID: 34217615 DOI: 10.1016/j.acra.2021.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/15/2021] [Accepted: 05/17/2021] [Indexed: 11/01/2022]
Abstract
Feedback is a critical part of the learning process and is a valuable tool to empower adult learners. Modern feedback theory places the learner at the center of the feedback encounter. Individual and institutional barriers to effective giving and receiving of feedback can be overcome through education and attention to the form and content of feedback. We review the elements of effective feedback and address issues of framing, environmental, and social factors which aid in providing psychological safety and trust, as necessary elements to create a culture of feedback in radiology training programs. We provide practical strategies to empower learners with the necessary skills to solicit, receive, and reflect on feedback.
Collapse
|
43
|
Oliveira A, Slanetz PJ, Catanzano TM, Sarkany D, Siddall K, Johnson K, Jordan SG. Strengthening the Clinical Learning Environment by Mandate-Implementing the ACGME Common Program Requirements. Acad Radiol 2022; 29 Suppl 5:S65-S69. [PMID: 33303348 DOI: 10.1016/j.acra.2020.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/21/2020] [Accepted: 11/25/2020] [Indexed: 11/01/2022]
Abstract
RATIONALE Three years ago, the Accreditation Council for Graduate Medical Education (ACGME) introduced updated Common Program Requirements in recognition of the need to further promote resident and faculty member well-being and patient safety. The ACGME acknowledged residencies would need time to comply with new requirements. This grace period, however, concluded as of July 1, 2019, and programs now risk citations for failure to implement new requirements. METHODS AND RESULTS The authors, members of the Association of Program Directors in Radiology Common Program Requirements Ad Hoc committee, developed downloadable resources provided in the Appendix delineating the 2019 Common Program Requirements and offering sample resources as compliant solutions. CONCLUSION The resources offer a national standardized approach to educating trainees in these essential skills and should be especially helpful to programs with access to fewer resources. In addition to achieving compliance, incorporation of these resources into residency training will ensure the next generation of radiologists are equipped to add value while remaining physically and emotionally healthy.
Collapse
|
44
|
Affiliation(s)
- Priscilla J Slanetz
- Vice Chair of Academic Affairs in the Department of Radiology and Associate Program Director of the Diagnostic Radiology Residency, Boston University Medical Center, Boston, Massachusetts, and also is from Boston University School of Medicine, Boston, Massachusetts; Director of Early Career Faculty Development and Co-Director of the Academic Writing Program for Boston University Medical Group; President of Massachusetts Radiological Society; Vice President of the Association of University Radiologists; and Subspecialty Chair of the ACR Appropriateness Criteria Breast Imaging Panels.
| | - Lori A Deitte
- Vice Chair of Education, Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee; Chair of the Commission on Publications and Lifelong Learning; and Member of the Board of Chancellors of the American College of Radiology
| |
Collapse
|
45
|
Slanetz PJ, Ngo M, Ali K, Chapman T. The Radiology Residency Application Arms Race—Is Preference Signaling the Answer? J Am Coll Radiol 2022; 19:779-781. [PMID: 35427540 PMCID: PMC9002318 DOI: 10.1016/j.jacr.2022.02.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 11/11/2022]
|
46
|
Kressin NR, Wormwood JB, Battaglia TA, Maschke AD, Slanetz PJ, Pankowska M, Gunn CM. Women's Understandings and Misunderstandings of Breast Density and Related Concepts: A Mixed Methods Study. J Womens Health (Larchmt) 2022; 31:983-990. [DOI: 10.1089/jwh.2021.0343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Nancy R. Kressin
- Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Jolie B. Wormwood
- Department of Psychology, University of New Hampshire, Durham, New Hampshire, USA
| | - Tracy A. Battaglia
- Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Ariel D. Maschke
- Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Priscilla J. Slanetz
- Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Magdalena Pankowska
- Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Christine M. Gunn
- Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts, USA
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
| |
Collapse
|
47
|
DeBenedectis CM, Spalluto LB, Americo L, Bishop C, Mian A, Sarkany D, Kagetsu NJ, Slanetz PJ. Health Care Disparities in Radiology-A Review of the Current Literature. J Am Coll Radiol 2022; 19:101-111. [PMID: 35033297 DOI: 10.1016/j.jacr.2021.08.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/31/2021] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Health care disparities exist in all medical specialties, including radiology. Raising awareness of established health care disparities is a critical component of radiology's efforts to mitigate disparities. Our primary objective is to perform a comprehensive review of the last 10 years of literature pertaining to disparities in radiology care. Our secondary objective is to raise awareness of disparities in radiology. METHODS We reviewed English-language medicine and health services literature from the past 10 years (2010-2020) for research that described disparities in any aspect of radiologic imaging using radiology search terms and key words for disparities in OVID. Relevant studies were identified with adherence to the guidelines set forth by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. RESULTS The search yielded a total 1,890 articles. We reviewed the citations and abstracts with the initial search yielding 1,890 articles (without duplicates). Of these, 1,776 were excluded based on the criteria set forth in the methods. The remaining unique 114 articles were included for qualitative synthesis. DISCUSSION We hope this article increases awareness and inspires action to address disparities and encourages research that further investigates previously identified disparities and explores not-yet-identified disparities.
Collapse
Affiliation(s)
- Carolynn M DeBenedectis
- Vice-Chair, Education; Director, Radiology Residency Program; Department of Radiology, President-elect, New England Roentgen Ray Society; and Department of Radiology, University of Massachusetts Medical School, Worcester, Massachusetts.
| | - Lucy B Spalluto
- Vice-Chair, Health Equity; Director, Women in Radiology; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee; Vanderbilt Ingram Cancer Center, Nashville, Tennessee; Veterans Health Administration-Tennessee Valley Healthcare System Geriatric Research; and Education and Clinical Center (GRECC), Nashville, Tennessee
| | - Lisa Americo
- Department of Radiology, Staten Island University Hospital Northwell Health, Staten Island, New York
| | - Casey Bishop
- Department of Radiology, Boston Medical Center, Boston, Massachusetts
| | - Asim Mian
- Director, Radiology Residency Program; Department of Radiology, Boston Medical Center, Boston, Massachusetts
| | - David Sarkany
- Director, Radiology Residency Program; Department of Radiology, Staten Island University Hospital Northwell Health, Staten Island, New York
| | - Nolan J Kagetsu
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Priscilla J Slanetz
- Vice-Chair, Academic Affairs; Associate Program Director, Radiology Residency Program, Boston Medical Center; President-elect Massachusetts Radiologic Society; Secretary, Association of University Radiologists; Chair, Breast Imaging Panel 2, ACR Appropriateness Guidelines Committee; and Department of Radiology, Boston Medical Center, Boston, Massachusetts
| |
Collapse
|
48
|
Gao Y, Karimova EJ, Phillips J, Fein-Zachary V, Dialani V, Mehta TS, Mehta R, Slanetz PJ. Injected Breast Materials: Review of Imaging Features and Characteristics. J Breast Imaging 2021; 3:727-739. [PMID: 38424927 DOI: 10.1093/jbi/wbab035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Indexed: 03/02/2024]
Abstract
In the United States, silicone and saline breast implants with their familiar radiologic appearance are the mainstays of breast augmentation. However, less well-known sequelae of unconventional injected materials introduced for cosmetic and noncosmetic purposes may also be encountered on breast imaging-for example, free silicone, paraffin and/or oil, polyacrylamide gel, autologous fat, and hyaluronic acid, which are encountered in the setting of breast augmentation. Breast injection of go-yak is not cosmetic but also results in characteristic imaging findings. Breast changes due to extravasation of chemotherapy or interstitial brachytherapy can mimic the appearance of injected noncosmetic materials. Because many of these materials can mimic or obscure imaging findings of breast cancer, it is important to recognize their varied appearances and the limitations of imaging alone in delineating breast injection material from cancer. Given the relatively uncommon incidence of injected materials into the breast, this article aims to review the imaging appearance in order to aid radiologists in maximizing cancer detection and ensuring optimal patient management.
Collapse
Affiliation(s)
- Yukun Gao
- Beth Israel Deaconess Medical Center, Department of Radiology, Boston, MA, USA
| | - E Jane Karimova
- Brigham and Women's Hospital, Department of Radiology, Boston, MA, USA
| | - Jordana Phillips
- Beth Israel Deaconess Medical Center, Department of Radiology, Boston, MA, USA
| | | | - Vandana Dialani
- Beth Israel Deaconess Medical Center, Department of Radiology, Boston, MA, USA
| | - Tejas S Mehta
- Beth Israel Deaconess Medical Center, Department of Radiology, Boston, MA, USA
| | - Rashmi Mehta
- Beth Israel Deaconess Medical Center, Department of Radiology, Boston, MA, USA
| | | |
Collapse
|
49
|
Harfouch N, Grunhut J, Hsu A, Pinsky S, Chacko J, Raden M, Slanetz PJ, Sarkany D. MD and DO: Differing Medical Degrees and the Associated Perceptions. Curr Probl Diagn Radiol 2021; 50:820-824. [DOI: 10.1067/j.cpradiol.2020.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/11/2020] [Accepted: 08/21/2020] [Indexed: 11/22/2022]
|
50
|
Weinstein SP, Slanetz PJ, Lewin AA, Battaglia T, Chagpar AB, Dayaratna S, Dibble EH, Goel MS, Hayward JH, Kubicky CD, Le-Petross HT, Newell MS, Sanford MF, Scheel JR, Vincoff NS, Yao K, Moy L. ACR Appropriateness Criteria® Supplemental Breast Cancer Screening Based on Breast Density. J Am Coll Radiol 2021; 18:S456-S473. [PMID: 34794600 DOI: 10.1016/j.jacr.2021.09.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 09/01/2021] [Indexed: 11/18/2022]
Abstract
Mammography remains the only validated screening tool for breast cancer, however, there are limitations to mammography. One of the limitations of mammography is the variable sensitivity based on breast density. Supplemental screening may be considered based on the patient's risk level and breast density. For average-risk women with nondense breasts, the sensitivity of digital breast tomosynthesis (DBT) screening is high; additional supplemental screening is not warranted in this population. For average-risk women with dense breasts, given the decreased sensitivity of mammography/DBT, this population may benefit from additional supplemental screening with contrast-enhanced mammography, screening ultrasound (US), breast MRI, or abbreviated breast MRI. In intermediate-risk women, there is emerging evidence suggesting that women in this population may benefit from breast MRI or abbreviated breast MRI. In intermediate-risk women with dense breasts, given the decreased sensitivity of mammography/DBT, this population may benefit from additional supplemental screening with contrast-enhancedmammography or screening US. There is strong evidence supporting screening high-risk women with breast MRI regardless of breast density. Contrast-enhanced mammography, whole breast screening US, or abbreviated breast MRI may be also considered. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
Collapse
Affiliation(s)
- Susan P Weinstein
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Priscilla J Slanetz
- Panel Chair, Boston University School of Medicine, Boston, Massachusetts; and President, Massachusetts Radiological Society
| | - Alana A Lewin
- Panel Vice-Chair, New York University School of Medicine, New York, New York
| | - Tracy Battaglia
- Director, Womens Health Unit, Associate Director, Belkin Breast Health Center, Boston Medical Center and Boston University School of Medicine and Public Health, Boston, Massachusetts; and Chair, National Navigation Roundtable
| | - Anees B Chagpar
- Yale School of Medicine, New Haven, Connecticut; Society of Surgical Oncology
| | - Sandra Dayaratna
- Thomas Jefferson University Hospital, Robbinsville, New Jersey; American College of Obstetricians and Gynecologists
| | | | - Mita Sanghavi Goel
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois; American College of Physicians
| | | | | | - Huong T Le-Petross
- The University of Texas MD Anderson Cancer Center, Houston, Texas; and Breast Imaging Lead in Prevention, Breast Committee, DI Committee of the Alliance
| | - Mary S Newell
- Emory University Hospital, Atlanta, Georgia; Governor, ABR; and Board Member, SBI
| | | | - John R Scheel
- Fellowship Director, University of Washington, Seattle, Washington
| | - Nina S Vincoff
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York
| | - Katherine Yao
- NorthShore University HealthSystem, Evanston, Illinois; Vice Chair, National Accreditation Program for Breast Centers; and American College of Surgeons
| | - Linda Moy
- Specialty Chair, NYU Clinical Cancer Center, New York, New York; Chair, ACR NMD Registry; Senior Deputy Editor, Radiology; and Advisory Board, iCAD and Lunit
| |
Collapse
|