Breast Cancer Detection and Screening in Dense Breasts

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Breast Sonography: 1.50
Patient Care: 0.75
Patient Interactions and Management: 0.75
Procedures: 0.75
Anatomy and Physiology: 0.75

Mammography: 2.50
Patient Care: 0.50
Patient Interactions and Management: 0.50
Procedures: 2.00
Anatomy, Physiology, and Pathology: 1.50
Mammographic Positioning, Special Needs, and Imaging Procedures: 0.50

Magnetic Resonance Imaging: 0.50
Procedures: 0.50
Body: 0.50

Registered Radiologist Assistant: 2.50
Procedures: 2.50
Thoracic Section: 2.50

Sonography: 0.50
Procedures: 0.50
Superficial Structures and Other Sonographic Procedures: 0.50

Radiation Therapy: 1.50
Patient Care: 1.50
Patient and Medical Record Management: 1.50

Outline

1. Introduction

Objectives

Upon completion of this course, students will:

1. understand the association of dense breast tissue with breast cancer incidence and mortality rate
2. recall the decrease in breast cancer deaths since 1989
3. state the screening modality proven to reduce breast cancer deaths
4. discuss the glandular and fat elements of dense breasts
5. list the four categories of BI-RADS breast density
6. relate the percentage of dense breasts in women aged 40 years and older
7. list factors that can increase breast density
8. know which BI-RADS edition stipulates a subjective assessment of breast density
9. explain inter-reader and intra-reader mammography variability
10. know the strongest independent risk factors for developing breast cancer aside from age and genetics
11. recall the breast cancer risk for patients with extremely dense breasts as compared to the risk for patients with fatty breast
12. define interval cancer
13. know how many more times likely it is for interval cancers to develop in dense breasts
14. differentiate between breast density studies
15. know the sensitivity of mammography as it applies to increasing breast density
16. explain the mortality rate benefit of screening mammography
17. recall the year that breast density legislation began
18. know which state was first to mandate coverage for supplemental screening and that patients be sent letters to inform them about breast density after they undergo mammography
19. state the year that the U.S. Congress passed a national breast density reporting law
20. name the month and year the U.S. FDA finalized language for mammography centers to inform women about dense breasts
21. recite the year in which the Find It Early Act was introduced
22. interpret data in order to understand participant eligibility criteria
23. list the benefits of digital breast tomosynthesis
24. state the mean interpretation time for mammography with digital breast tomosynthesis as compared to full field digital mammography
25. choose the plane in which digital spot compression views can be taken in order to assist with identifying spiculations
26. differentiate between blind spots, forbidden zones, and no-man’s land on mammograms
27. note where the no-man’s land of the breast can be found
28. explain the types of cancers that can be identified when using supplemental screening ultrasound in patients with dense breasts
29. state the positive predictive value of handheld ultrasound
30. state the ACR false-positive benchmark for mammography
31. list the advantages of automated breast ultrasound over handheld ultrasound
32. recall what percent of breast cancers are occult at US and mammography
33. list the specific disadvantages of handheld ultrasound
34. list the limitations for automated breast ultrasound
35. indicate the features seen with malignant non-mass lesions seen at ultrasound
36. define which anatomic plane specific to automated breast ultrasound shows the breast as it would appear on the operating table
37. choose the year in which contrast enhanced mammography was approved by the U.S. Food and Drug Administration for diagnostic purposes
38. list the main disadvantages of contrast enhanced mammography
39. list the most common benign lesions that may enhance on contrast enhanced mammography