Impact of Mammographic Breast Density on Breast Cancer Risk

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.]

Mammography: 2.00
Patient Care: 1.00
Patient Interactions and Management: 1.00
Procedures: 1.00
Anatomy, Physiology, and Pathology: 1.00

Outline

1. Introduction
2. What is Mammographic Density
3. Accuracy and Variability of Density Classification
4. Breast Density and the Risk for Breast Cancer
   1. Masking Effect
   2. Density as an Independent Risk Factor
   3. Current State of Legislation Regarding Breast Density Notification
5. Evidence for Supplemental Screening
   1. Digital Mammography
   2. Digital Breast Tomosynthesis
   3. Whole-Breast US
   4. MR Imaging
6. Expert Guidelines on Supplemental Screening
7. The Information Age and Evidence-based Medicine
8. Conclusion

Objectives

Upon completion of this course, students will:

1. state the number of states with recent legislative changes in regard to patient notification of breast density
2. list the critical concepts regarding breast density that radiologists must understand in depth
3. define breast density
4. express who first described different parenchymal density patterns
5. articulate what the acronym BIRADS stands for
6. specify the four categories of the BIRADS lexicon
7. differentiate between percentages from data about breast density
8. describe inter-reader percentages between different studies
9. discriminate between classification system types to measure breast density
10. describe how positioning of the breast affects objective measurements of breast density
11. select the factors that cause breast density to decrease
12. state how breast density affects mammographic screening
13. contrast mammographic sensitivity and breast density
14. describe the method used to make the comparison between mammographic sensitivity and breast density
15. define interval cancer
16. verbalize the benefit to shorter screening intervals for women with dense breasts
17. specify the type of cells most conducive to breast cancer development
18. list the major risk factors for breast cancer
19. list the breast density classification systems
20. name the state where breast density legislation was first passed
21. specify the year federal legislation regarding breast density notification was first introduced
22. differentiate between imaging characteristics that effect digital mammograms
23. express the percentage of facilities in the United States that utilize digital mammography
24. state the year digital breast tomosynthesis was approved by the FDA
25. describe how digital breast tomosynthesis creates breast images
26. list the limiting factors affecting the true impact of digital breast tomosynthesis
27. state supplemental screening tools that have not been evaluated via randomized trials
28. note the study providing the most relevant data regarding the benefit of whole-breast ultrasound
29. list the benefits of automated whole-breast ultrasound
30. state the year when the FDA approved automated whole-breast ultrasound
31. state the supplemental breast screening modality that is neither recommended for or against in women with the risk factor of dense breasts
32. list the obstacles that can limit the use of MR imaging as a breast cancer screening tool
33. express screening tests that have been shown to reduce the mortality from breast cancer
34. state the driving factors for breast density legislation
35. state the benefit of increased information to patients in regard to breast healthcare options