In radiology, testing new ways to screen for breast diseases

Read our free special article collection for the International Day of Radiology

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Radiology plays a critical role in detecting, diagnosing and treating breast cancer and other diseases of the breast. On November 8 – the International Day of Radiology – this role is being highlighted by radiology societies around the world.

Advances in technology are helping refine and improve the radiological methods used to screen for and diagnose breast diseases. With new machines and analytical techniques, breast cancers and other diseases can be spotted earlier, helping increase the likelihood of the patient being cured. When women are invited to breast screening, there is a 20 percent reduction in breast cancer mortality, according to recent research.

Organized annually by the European Society of Radiology, the American College of Radiology and the Radiological Society of North America, the International Day of Radiology aims to raise awareness of radiology in breast diseases, including the importance of using the correct doses of radiation in medical imaging.

To mark the day, we have collected 14 recent articles published in Elsevier’s radiology-related journals. They are free to access until February 2, 2017.

New technologies, better screening

Breast screening has been shown to reduce breast cancer deaths, but the standard method, called full-field digital mammography (FFDM), still misses 15-30 percent of cancers, particularly in dense breast tissue. A new technique for screening – digital breast tomosynthesis (DBT) –could improve the rate of cancer detection.

DBT uses x-ray radiation to produce multiple images across sections of the breast, rather than a single image from one angle. Because of this, it is more effective at revealing disease in dense breast tissue. A team of researchers from the University of York in the UK, Referenzzentrum Mammographie München in Germany and Johns Hopkins Medical Institute in the United States conducted a systematic review of the research on DBT, published in The Breast.

The team compared the performance of the standard technique FFDM with DBT alone, DBT with FFDM, and DBT with another technique (synthetic digital mammography) for detecting breast cancer lesions in women with no symptoms of disease. They analyzed five studies – two from Europe and one from the US. Both European studies revealed that DBT and FFDM together resulted in better detection rates and lower false positives. All three US studies showed lower false positives for DBT and FFDM together, but only the largest study showed a significant improvement in detection rates.

Challenges with new method

Writing in Clinical Radiology, researchers from the University of Cambridge in the UK explore some of the challenges associated with the method. Using DBT as a screening tool means radiologists need to spend more time reading the images, and the method requires additional IT storage and connectivity. It is also unclear whether the technology is cost effective. The authors of the study call for more trials to clarify whether this method could help improve screening outcomes and ultimately survival rates.

Helping patients deal with false positives

One of the most significant outcomes of a false positive diagnosis is that the patient can experience stress. As the people responsible for interpreting the images taken during screening, radiologists can help reduce the stress of over-diagnosis. In an article in Academic Radiology, researchers from the University of Washington School of Medicine, University of Washington School of Public Health, University of Pennsylvania and Hutchinson Institute for Cancer Outcomes Research, all in the US, explore ways the community is mitigating the potential harms associated with screening.

While there are still risks of over-diagnosis, helping patients understand this and take part actively in their own diagnosis and treatment can help reduce stress. One approach is to offer patients information and the opportunity to ask healthcare professionals questions. Researchers from New York University School of Medicine and the University of Colorado School of Medicine in the US assessed the impact of public lectures on 117 patients.

The results, published in the Journal of the American College of Radiology, show that those who attended the sessions reported decreased anxiety and increased knowledge about the screening process. This, they conclude, helps enable patients to make informed decisions and may also encourage more people to attend screening.

Special collection: Radiology in breast diseases

Read more about these studies and many others in our special collection to mark International Day of Radiology 2016. This collection of articles is free to access until February 2, 2017.

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