By Kate Madden Yee, AuntMinnie.com staff writer
November 10, 2010

At this year's RSNA conference, watch for presentations in women's imaging that explore ways to screen for breast cancer more effectively, according to breast imaging subcommittee member Constance Lehman, MD, PhD, section head of breast imaging at the University of Washington in Seattle.

"For breast imagers, there's continued drive in clinical research to find better methods for early breast cancer detection," Lehman told AuntMinnie.com. "Although we strongly recommend annual mammographic screening for women age 40 and older, we do know that mammography is imperfect and we are striving to find better methods of screening."

Attendees can check out two "Hot Topic" presentations at the conference: One will explore the use of digital breast tomosynthesis as a breast imaging technique (Wednesday, December 1, SH40, 7:15 a.m-8:15 a.m., Room E351), and another will examine national and international perspectives on screening mammography (Thursday, December 2, SH53, 3:00 p.m.-4:00 p.m., Room E353C).

Also at the RSNA meeting, breast MRI's capabilities will be highlighted, Lehman said, with papers focusing on how preoperative breast MRI affects patient outcomes and how MRI can be used as a screening tool for women at increased risk of breast cancer.

"In 2007, the American Cancer Society began recommending that women with a family and genetic history of breast cancer be screened with MRI," she said. "At that time, there was insufficient evidence to recommend for or against screening of women with a personal history of breast cancer but no known family history. At this year's meeting, there will be studies presented that support screening of this specific subgroup of women."

Also of interest on the breast MRI front during the conference will be studies on new applications of the technology, including diffusion MRI, which doesn't require contrast, but rather measures the movement of water within different types of breast tissue and may improve MRI's specificity in breast imaging, according to Lehman.

"Diffusion MRI has been used in brain imaging, and there are very exciting applications for it with breast cancer," she said. "Diffusion MRI gives more information about the breast tissue and, as such, can improve MRI's specificity, therefore helping to guide clinicians' final biopsy decisions. And if breast MRI is ever to be used as a screening tool, having a way to use it that is fast, does not use contrast, and is easier to read would be much more feasible."

Also highlighted will be advanced imaging technologies, such as FDG-PET and breast-specific gamma imaging (BSGI), that offer not only anatomic information but also functional data such as how a tumor is behaving and what is feeding it -- which, in turn, can lead to more targeted breast cancer therapy. (Take a look at multisession course VM21, being held on Monday, November 29, from 8:30 a.m.-12:00 p.m. in the Arie Crown Theater.)

Finally, attendees will be able to view a number of posters that address specific breast cancer features and how to identify them with various imaging modalities (see posters LL-BRE2042, LL-BRE3273, and LL-BRE3274). And in the computer-aided detection (CAD) arena, a refresher course called "New Trends in Breast CAD" will be offered on Tuesday, November 30 (RC321A, B, and C; 8:30 a.m.-10:00 a.m.; Room S503AB).

Read on for more highlights of some of the more intriguing women's imaging papers scheduled for presentation at this year's RSNA meeting. To view the RSNA's listing of abstracts for this year's scientific and educational program, click here.

Scientific and Educational Presentations
Preoperative breast MRI doesn't increase mastectomy rates
Sunday, November 28 | 11:25 a.m.-11:35 a.m. | SSA01-05 | Arie Crown Theater
Preoperative MRI can be used in clinical practice for breast cancer staging without boosting mastectomy rates, according to researchers from the University of Milan School of Medicine.
MBI increases breast cancer detection in dense tissue
Monday, November 29 | 8:55 a.m.-9:05 a.m. | VM21-03 | Arie Crown Theater
In this paper presentation, researchers from the Mayo Clinic in Rochester, MN, will discuss how adding molecular breast imaging (MBI) to regular screening mammography for women with dense breasts increases cancer detection.
BSGI improves breast cancer detection -- but biopsies may still be needed
Monday, November 29 | 9:05 a.m.-9:15 a.m. | VM21-04 | Arie Crown Theater
Breast-specific gamma imaging (BSGI) improves the detection of breast cancer, but the modality doesn't do away with the need for biopsy when indicated by mammography or ultrasound, according to researchers from Weinstein Imaging Associates in Pittsburgh.
Positron emission mammography can be more specific than MRI
Monday, November 29 | 9:25 a.m.-9:35 a.m. | VM21-06 | Arie Crown Theater
Positron emission mammography (PEM) is more specific than MRI for surgical management in women with ipsilateral breast cancer, according to researchers from Johns Hopkins at Green Spring Station in Lutherville, MD.
PEM shows potential for breast cancer surgical planning
Monday, November 29 | 11:40 a.m.-11:50 a.m. | VM21-15 | Arie Crown Theater
In this scientific session, Johns Hopkins researchers will present study results suggesting that positron emission mammography (PEM) is a helpful tool for breast cancer surgical planning in early-stage breast cancer.
Targeted breast US identifies cancer BI-RADS 3 lesions found by MRI
Monday, November 29 | 3:00 p.m.-3:10 p.m. | SSE01-01 | Room E450A
Using targeted ultrasound on breast lesions identified as BI-RADS category 3 by MRI can help identify malignancies, according to researchers from Brown University in Providence, RI.
Breast MRI shows high negative predictive value in BI-RADS 3 lesions
Monday, November 29 | 3:20 p.m.-3:30 p.m. | SSE01-03 | Room E450A
Breast MRI exhibits a high negative predictive value in patients with BI-RADS category 3 lesions, according to a study from the Medical University of Graz in Graz, Austria, to be presented on Monday.
CAD aids in assessing amorphous breast calcifications
Tuesday, November 30 | 11:30 a.m.-11:40 a.m. | SSG01-07 | Room E450A
In this scientific session, researchers from Princess Margaret Hospital in Toronto will present data showing a high sensitivity for computer-aided detection (CAD) in detecting amorphous calcifications on full-field digital mammography (FFDM) studies.
'Multiple-bilateral' breast mass malignancy rate comparable to similar lesions
Tuesday, November 30 | 3:00 p.m.-3:10 p.m. | SSJ02-01 | Room E450A
Malignancy rates for multiple-bilateral breast masses detected at whole-breast ultrasound are comparable to rates for masses with similar features but not categorized as multiple-bilateral, according to researchers from Johns Hopkins at Green Spring Station in Lutherville, MD.
Targeted 'second-look' ultrasound finds additional, smaller lesions
Tuesday, November 30 | 3:40 p.m.-3:50 p.m. | SSJ02-05 | Room E450A
Using ultrasound to take a second look at women with breast cancer who have already undergone mammography and an initial ultrasound can help find additional, smaller malignant lesions, but many of these belong to lower-risk BI-RADS categories, according to researchers from Hospital Universitario 12 de Octubre in Madrid.
Contrast-enhanced spectral mammography proves useful adjunct
Wednesday, December 1 | 8:35 a.m.-8:45 a.m. | VB41-01 | Arie Crown Theater
In this paper presentation, researchers will discuss study results showing contrast-enhanced spectral mammography's (CESM) potential to increase the performance and sensitivity of standard mammography and breast ultrasound.
DBT equivalent to FFDM for cancer detection
Wednesday, December 1 | 10:25 a.m.-10:35 a.m. | VB41-08 | Arie Crown Theater
Digital breast tomosynthesis (DBT) finds and identifies breast cancers just as well as full-field digital mammography (FFDM), according to a study to be presented on Wednesday by researchers from Albert Einstein Medical Center in Philadelphia.
Shear-wave elastography improves ultrasound diagnosis of breast masses
Wednesday, December 1 | 11:25 a.m.-11:35 a.m. | VB41-13 | Arie Crown Theater
When used with B-mode ultrasound, shear-wave elastography -- which quantitatively measures soft-tissue stiffness in real-time -- can improve the modality's specificity without compromising its sensitivity, according to researchers from Imperial College London in the U.K.
MRI useful in evaluating pregnant patients with right lower quadrant pain
Wednesday, December 1 | 11:50 a.m.-12:00 p.m. | SSK08-09 | Room S102D
MRI is valuable in evaluating pregnant patients with right lower quadrant pain, according to a new scientific paper by researchers from Johns Hopkins University in Baltimore.
Targeted ultrasound best for biopsy after incidental breast MRI findings
Wednesday, December 1 | 3:10 p.m.-3:20 p.m. | SSM02-02 | Room E450A
Breast MRI can find additional lesions when used as an adjunct to mammography and ultrasound, but it's also associated with a higher false-positive rate, according to Italian researchers. Using targeted ultrasound with these incidental MRI lesions offers a way to reduce false positives.
DBT improves sensitivity, specificity of mammography
Thursday, December 2 | 10:40 a.m.-10:50 a.m. | SSQ01-02 | Arie Crown Theater
Digital breast tomosynthesis (DBT) reduces the problem of tissue superimposition, thus improving both the sensitivity and specificity of mammography in diagnosis and screening, according to researchers from King's College Hospital in London.

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