Breast Intervention

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification for enrollments starting after May 25, 2023:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Breast Sonography: 4.25
Patient Care: 1.50
Patient Interactions and Management: 1.50
Procedures: 2.75
Breast Interventions: 2.75

Mammography: 4.25
Procedures: 4.25
Mammographic Positioning, Special Needs, and Imaging Procedures: 4.25

Magnetic Resonance Imaging: 4.25
Patient Care: 1.50
Patient Interactions and Management: 1.50
Procedures: 2.75
Body: 2.75

Nuclear Medicine Technology: 3.00
Patient Care: 1.50
Patient Interactions and Management: 1.50
Procedures: 1.50
Endocrine and Oncology Procedures: 1.50

Registered Radiologist Assistant: 4.25
Procedures: 4.25
Thoracic Section: 4.25

Sonography: 4.25
Patient Care: 1.50
Patient Interactions and Management: 1.50
Procedures: 2.75
Superficial Structures and Other Sonographic Procedures: 2.75

Radiation Therapy: 2.75
Patient Care: 2.75
Patient and Medical Record Management: 2.75

Outline

1. Introduction
2. Validation of Percutaneous Image-guided Biopsy
3. Current Procedures
   1. Preprocedural Considerations
   2. Stereotactic Biopsy
      1. Indications
      2. Equipment
      3. Technique
      4. Potential Challenges
   3. US-guided Biopsy
      1. Indications
      2. Equipment
      3. Technique
   4. MR-guided Biopsy
      1. Indications
      2. Equipment
      3. Technique
   5. Postprocedure Considerations
4. Summary

Objectives

Upon completion of this course, students will:

1. list the advantages of image-guided breast biopsy over surgical biopsy
2. define success for core needle biopsy programs
3. understand the type of biopsy using a thin hollow needle for removing cell samples
4. specify the percent of image-guided percutaneous breast biopsies performed in the U.S. annually
5. state the percentage of benign breast biopsies performed in the U.S.annually
6. explain how palpable lesions not seen on imaging are biopsied
7. list the components of a long-throw, spring-loaded biopsy needle
8. distinguish between tissue troughs for long and short-throw needle systems
9. explain requirements when discordance between imaging and pathology occurs
10. differentiate between concordance and discordance with regard to imaging and pathology findings
11. compare and contrast BI-RADS codes
12. know the risks involved in an image-guided breast biopsy
13. understand discontinuation of aspirin and Coumadin pre-biopsy
14. distinguish between multi-focal and multi-centric
15. recognize the most frequently used imaging modalities for image-guided breast biopsy
16. categorize equipment used for image-guided breast biopsy
17. explain ways to increase patient understanding and cooperation during breast biopsy
18. recognize routine information required on written informed consent
19. define “timeout”
20. list potential complications associated with ultrasound-guided breast biopsy
21. list contraindications for image-guided breast biopsy
22. differentiate between sensitivity and specificity
23. indicate appropriateness for stereotactic biopsy technique
24. describe table systems for stereotactic breast biopsy
25. state the advantages of using a dedicated prone biopsy table
26. list patient positioning options when using an upright biopsy unit
27. identify factors needed to determine biopsy needle approach in stereotactic technique
28. describe how accurate needle placement is confirmed in stereotactic breast biopsy
29. explain how to minimize the accordion effect
30. list challenges to stereotactic breast biopsy
31. explain equipment adaptations that help alleviate negative stroke margin
32. identify advantages of ultrasound-guided breast biopsy
33. know the transducer strength needed for highest quality US guided breast biopsy
34. describe advantages to hand-held VAD for ultrasound breast biopsy
35. describe ultrasound biopsy patient positioning for solid lesions
36. explain US guided breast biopsy patient positioning for medially located lesions
37. state the best method to visualize needle route during US guided breast biopsy
38. explain advantages of dermatotomy
39. verbalize the number of core samples taken during US guided breast biopsy
40. explain marker migration in US guided breast biopsy
41. determine indicating factors for MR-guided breast biopsy
42. note the magnet strength required for MR-guided breast biopsy procedures
43. list imaging professionals who are part of the MR-guided breast biopsy team
44. describe patient positioning for MR-guided breast biopsy
45. state how benign concordant lesions are followed after MR-guided biopsy