Maimone Santo, McDonough Michelle
Department of Radiology, Mayo Clinic Florida, Jacksonville, Florida.
Breast J. 2017 Mar;23(2):193-199. doi: 10.1111/tbj.12712. Epub 2016 Oct 31.
Dense breast parenchyma obscures breast lesions and has been shown to be an independent risk factor for development of breast cancer. An ever-increasing number of states have approved laws requiring patient notification of dense breast tissue. Reviews of supplemental screening imaging modalities are available, but there is no consensus and little discussion regarding what radiologists are specifically doing to manage patients with dense breasts. Our goal was to survey breast imagers facing these issues in an effort to simplify dense breast management. A survey was administered via email to the Society of Breast Imaging member directory, designed to collect information regarding current practices in dense breast notification and supplemental screening. There were 223 surveys completed to entirety, including 38% from respondents in states without mandatory breast density reporting laws and 62% from states with reporting laws. A majority of respondents from both groups, 60% and 51% in those without and with laws, respectively, felt they lacked adequate resources to offer or sustain supplemental screening. In those offering supplemental imaging, the modalities offered varied widely as did the manner of offering a supplemental exam. Levels of satisfaction, concerns, and standard practices of respondents were also queried. Strategizing optimal imaging approaches and algorithms to handle dense breast management issues is important to maintain efficiency in breast imaging departments. Sharing current ideas and practices may facilitate a smoother workflow in mandatory dense breast reporting and supplemental imaging, allowing breast imagers to correct or prevent systems-based flaws.
致密的乳腺实质会掩盖乳腺病变，并且已被证明是乳腺癌发生的独立危险因素。越来越多的州已批准相关法律，要求告知患者其乳腺组织致密。虽然有关于补充筛查成像方式的综述，但对于放射科医生具体如何管理乳腺致密的患者，尚无共识且讨论很少。我们的目标是对面临这些问题的乳腺成像专家进行调查，以简化乳腺致密的管理。通过电子邮件向乳腺成像协会会员名录发放了一份调查问卷，旨在收集有关乳腺致密告知和补充筛查当前做法的信息。共完成了223份完整的调查问卷，其中38%的受访者来自没有强制乳腺密度报告法律的州，62%来自有报告法律的州。两组中的大多数受访者，即没有法律的州中的60%和有法律的州中的51%，都认为他们缺乏足够的资源来提供或维持补充筛查。在提供补充成像的受访者中，所提供的成像方式差异很大，提供补充检查的方式也是如此。还询问了受访者的满意度、关注点和标准做法。制定最佳成像方法和算法以处理乳腺致密管理问题对于维持乳腺成像部门的效率很重要。分享当前的想法和做法可能有助于在强制乳腺致密报告和补充成像方面实现更顺畅的工作流程，使乳腺成像专家能够纠正或预防基于系统的缺陷。
