Program Information
New Concepts in Breast Imaging
J Boone1*, A Hernandez2*, J Cord3*, (1) UC Davis Medical Center, Sacramento, CA, (2) University of California, Davis, CA, (3) Kaiser Permanente, Anaheim, CA
Presentations
MO-A-BRA-0 (Monday, March 7, 2016) 8:00 AM - 10:00 AM Room: Grand Ballroom A
Changing Perceptions and Updated Methods for Mammography Dosimetry
Mammography as a technology is changing, and previous dogma about breast geometry have changed as well. Consequently, there is a need for change in mammography dosimetry methods and tools. X-ray tube anodes in mammography have traditionally been molybdenum or rhodium, but the use of tungsten anodes has emerged on newer mammography systems, with different filter materials such as aluminum, silver, palladium, etc. Dose coefficients (DgN values) need to be updated to accommodate these new spectra. Three dimensional breast imaging modalities such as MRI and breast CT have generated new a understanding about the geometry of the breast, including a thinner skin layer (1.5 mm versus 4.0 mm), a dramatic change in the average breast density (~15% versus 50%), and a better description of the 3D distribution of glandular tissue in the breast (heterogeneous versus homogeneous) with a concomitant 30% reduction in DgN values which consider real heterogeneous breast geometry. This symposium will describe new x-ray system designs which impact dose assessment, and will also demonstrate how perceptions of breast geometry have changed using breast CT data sets. Using these new data, methods and tools for more accurate assessment of mean glandular dose will be described. A complete set of updated references for breast dosimetry will be provided to attendees.
Learning Objectives:
1. Previous assumptions about breast geometry have changed with the advent of 3D breast imaging using both MRI and breast CT
2. New data has led to a new understanding in the range of volume breast density, and in the normalized glandular dose coefficients (DgN) values used in computing breast dose.
3. Some new mammography systems use different x-ray target materials than the traditional Mo and Rh anodes, and practitioners need to make use of newly available tables for these more exotic anode / filter combinations.
4. The attendee should be able to identify new trends in breast geometry and mammography system design, and will be provided new DgN tables (as references) for producing more accurate MGD estimates in clinical practice.
Dense Breasts, Risk Stratification, DCIS Controversy & Genetic Based Risk Stratification – The Road to Customized Care
Mammography has been the standard for breast cancer mass population screening of asymptomatic women for decades. Our supplemental technologies are evolving and our understanding of genetic risk is constantly improving. Many modalities are competing with the status quo and the benefits of the current screening regimen are constantly being reevaluated and challenged. To complicate matters, our legislative bodies have responded with political elements and confusing messaging. All the while we seem to be diagnosing more breast cancer than ever! This session will take a journey through the various controversies showing the ever changing landscape of breast cancer screening highlighting the current controversies and their origins. We will then attempt to evaluate future directions and personalized screening potentials.
Learning Objectives:
1. Understand verbiage of “dense breast legislation”
2. Understand some of the controversy associated with aggressive imaging and over diagnosis
3. Be able to discuss weaknesses and strengths of alternative supplemental imaging modalities
4. Better understand genetic predisposition and risk specific screening options
5. Learn some of the current imaging recommendations for high risk women
6. Gain insight on evolving technologies
Handouts
- 113-31143-379492-117897-375415926.pdf (J Boone)
- 113-31144-379492-117898-1349471707.pdf (A Hernandez)
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