(Tuesday, 4/7/2020) 8:00 AM - 10:00 AM [Mountain Time (GMT-6)]
Part 1: Science and Evidence: Exposing the Misinformation Used to Confuse the Importance of Breast Cancer Screening
There has been a steady, decades-long effort to reduce access to breast cancer screening that continues today. As one impediment has been raised and refuted by the science, another is generated.
The benefits of early detection have been proven by randomized, controlled trials that showed “significant” mortality reduction for women who were invited to be screened and even fewer deaths among those who actually participated. The benefits have been confirmed in numerous observational studies involving hundreds of thousands of women in which women who participated in screening had fewer deaths than those who did not. Failure analyses have shown that women who died from breast cancer were much less likely to have participated in screening, and more recent “incidence of death” studies show that the incidence of death from breast cancer is much lower for women who participated in screening than those who did not despite having access to modern therapy.
In Part 1 of this session, various scientifically-unsupportable approaches to data analysis that have been used to try to mislead about the value of screening will be exposed and explained.
Learning Objectives:
Upon completion of this activity the participants will understand
1. The science and evidence that support screening for breast cancer starting at the age of 40.
2. The fact that there are no data to support the use of the age of 50 as a threshold for screening
3. The decades of misinformation denigrating breast cancer screening that have been refuted by the science and the evidence
Part 2: Contrast Enhanced Mammography: Physics and Clinical Applications
Mammography is a reliable imaging technique, but has limitations [especially] with dense breasts and for high risk patients. In the case of inconclusive mammography and ultrasound exams, breast MRI is the typical choice for the diagnostic exam. This presents a number of challenges, to both the health care provider (e.g., equipment costs and access) and the patient (e.g., anxiety over delayed diagnosis). Instead, contrast enhanced mammography (CEM) can be used as an alternative diagnostic exam. This fast, cost-effective exam is performed directly on a mammographic system, and consists of a contrast agent injection followed by a set of dual energy mammographic views. The combination of each dual energy image pair highlights areas of increased blood flow, and can be acquired and presented in the exact same position as the standard mammographic image.
In Part 2 of this session, the fundamental physics behind contrast enhanced mammography will be reviewed. Clinically, case-based examples highlighting the benefits of CESM will be shown.
Learning objectives:
Upon completion of this activity, participants will be able to:
1. Understand the physics and technology of contrast enhanced mammography.
2. Compare the outcomes from contrast enhanced mammography to those of digital mammography and digital breast tomosynthesis.
3. Assess the benefits of contrast enhanced mammography in the diagnostic evaluation of breast lesions.
4. Evaluate the impact of contrast enhanced mammography on the breast imaging clinical workflow.
Funding Support, Disclosures, and Conflict of Interest: Dr. Grant Stevens is an employee of GE Health Care.
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