Background
Dynamic contrast-enhanced MRI (DCE-MRI) is a revolution regarding screening and diagnosis of breast cancer. Yet, sometimes it is not the appropriate choice of imaging since the examination ...needs to be scheduled and may take place in another department. Contrast-enhanced mammography (CEM) is contrast-based digital mammogram, and consequently, it has emerged as a potential and promising replacer to DCE-MRI.
Main body of the abstract
There is a frequently asked question during the multidisciplinary breast cancer tumor boards is: which modality is more appropriate to be used in each clinical scenario? This article provided a detailed understanding of these two modalities in order to achieve a successful implementation of them into the clinical practice. Which modality to start with, in the context of the
detection
(screening) followed by characterization or
diagnosis
of the identified lesions? What is the appropriate application of both modalities in
local staging
and
follow-up
? All of these issues would be discussed in this article.
Short conclusion
MRI is a safe tool for breast imaging and has a superior diagnostic performance compared to CEM. However, CEM is getting close: this lies in its accessibility, short-time procedure, requirement of less training and feasibility to standardize.
Background
Risk factors are traits or behaviors that have an influence on the development of breast cancer (BC). Awareness of the prevalent risk factors can guide in developing prevention ...interventions.
Purpose
To evaluate the correlation between the breast density, body mass index, and the risk of breast cancer development in relation to the menopausal status in a native African-Arab population.
Material and methods
The study included 30,443 screened females who were classified into cancer and non-cancer groups and each group was further sub-classified into pre- and postmenopausal groups. The breast density (BD) was reported and subjectively classified according to the 2013 ACR BI-RADS breast density classification. The weight and height were measured, and the body mass index (BMI) was calculated and classified according to the WHO BMI classification.
Results
A statistically significant difference was calculated between the mean BMI in the cancer and non-cancer groups (p: .027) as well as between the pre- and postmenopausal groups (p < .001). A positive statistically insignificant correlation was calculated between the breast density and the risk of breast cancer in the premenopausal group (OR: 1.062, p: .919) and a negative highly significant correlation was calculated in the postmenopausal group (OR: 0.234, p < .001).
Conclusion
BMI and BD are inversely associated with each other. The current studied population presented unique ethnic characteristics, where a decreased BD and an increased BMI were found to be independent risk factors for developing breast cancer.
Lymphadenopathy (LAP) refers to abnormalities in the size or consistency of lymph nodes. A wide range of etiologies contributes to the difficulty in diagnosing LAP, from mild self-limited viral ...infections to grave autoimmune diseases and malignancies. Detailed history-taking and a thorough physical examination are essential. Some physicians in developing countries may consider therapeutic testing. Certain groups may require additional evaluations and special treatment. When treating LAP, the etiology is targeted, but corticosteroids should not be administered before a complete diagnosis has been established due to their ability to mask the histological diagnosis of lymphoma and malignancy. This review aims to provide more straightforward and affordable methods available in almost all healthcare settings, especially those with limited resources.
Background
In multidisciplinary education, different perspectives from more than one discipline are used to illustrate a certain topic. The aim of this study was to evaluate the effectiveness of an ...online, multidisciplinary radiology curriculum to teach radiology to medical students in Egypt. A multidisciplinary team of radiologists, surgeons, and internists taught a series of 5 case-based radiology sessions on a web conference platform. Topics included common clinical case scenarios for various body systems. Undergraduate medical students across Egypt were enrolled in the course. A pre-test–post-test design was used to evaluate the efficacy of each session. Upon course completion, students filled out a subjective survey to assess the radiology education series.
Results
On average, 1000 students attended each session. For each session, an average of 734 students completed both the pre-test and post-test. There was a statistically significant increase in post-test scores compared to pre-test scores across all 5 sessions (
p
< 0.001) with an overall average score improvement of 63%. A subjective survey at the end of the course was completed by 1027 students. Over 96% of students found the lecture series to be a worthwhile experience that increased their imaging knowledge and interest in radiology, and that the use of a multidisciplinary approach added educational value. About 66% of students also reported that the session topics were “excellent and clinically important.” There was a marked increase in reported confidence levels in radiology competencies before and after attendance of the sessions.
Conclusions
An online radiology curriculum with a multidisciplinary approach can be implemented successfully to reach a large group of medical students and meet their educational objectives.
Background
Radiology serves in the diagnosis and management of many diseases. Despite its rising importance and use, radiology is not a core component of a lot of medical school curricula. This ...survey aims to clarify current gaps in the radiological education in Egyptian medical schools. In February–May 2021, 5318 students enrolled in Egyptian medical schools were recruited and given a 20-multiple-choice-question survey assessing their radiology knowledge, radiograph interpretation, and encountered imaging experiences. We measured the objective parameters as a percentage. We conducted descriptive analysis and used Likert scales where values were represented as numerical values. Percentages were graphed afterwards.
Results
A total of 5318 medical students in Egypt answered our survey. Gender distribution was 45% males and 54% females. The results represented all 7 class years of medical school (six academic years and a final training year). In assessing students’ knowledge of radiology, most students (75%) reported that they received ‘too little’ education, while 20% stated the amount was ‘just right’ and only 4% reported it was ‘too much.’ Sixty-two percent of students stated they were taught radiology through medical imaging lectures. Participants’ future career plans were almost equally distributed. Near half of participants (43%) have not heard about the American College of Radiology Appropriateness Criteria (ACR-AR), while 39% have heard about it but are not familiar with.
Conclusions
Radiology is a novel underestimated field. Therefore, medical students need more imaging exposure. To accomplish this, attention and efforts should be directed toward undergraduate radiology education to dissolve the gap between radiology and other specialties during clinical practice. A survey answered by medical students can bridge between presence of any current defect in undergraduate radiology teaching and future solutions for this topic.
Background
There is a worldwide deficit in teaching and training in the field of radiology for undergraduate medical students. This educational gap is prominent in many medical schools as most ...radiology curricula are a part of other specialty trainings, usually provided by non-radiologists. After COVID-19 pandemic, there was an increased trend in online education. However, questions have been raised about the efficacy and acceptance of online education. We developed a course on the principles of radiology and medical imaging basics to target Egyptian medical students. We then assessed the impact of these educational videos through several online surveys. Our "The Principles of Radiology Online Course" was delivered to students at various Egyptian medical schools; it was a prerecorded series composed of nine sessions, and each session followed the sequence of a pre-test, video, and post-test. There was a final survey to assess the overall feedback. Finally, we analyzed the results to give insight onto how teaching radiology through online lectures can help build better physicians.
Results
Among various medical schools around Egypt, 1396 Egyptian medical students joined this cohort. Cohort population percentage was 56% female and 44% male. Ninety-eight percent of the students agreed that this program increased their understanding of radiology. Eighty-four percent of the students found the platform friendly and easy to use. Seventy-nine percent found these webinars were more convenient compared to in-person education. Statistical significance (
p-
value < 0.05) was achieved in all sessions after comparing students’ pre and post-test scores, and in students’ confidence and knowledge level before and after the course.
Conclusions
Radiology is an underrepresented subject for a lot of medical students. Online radiology webinars have proven to be a promising method of teaching medical students key medical imaging concepts. An online course of radiology basics and principles can help improve a medical student’s knowledge and enhance overall future patient care.
Hereditary Angioedema (HAE) attacks show an increased frequency and severity for pregnant and lactating females secondary to the hormonal changes. The diagnosis and management of HAE in pregnant and ...lactating females pose a challenge for physicians due to the rarity of the disease and the paucity of the data for specific management.
In this manuscript, we discuss the diagnosis and special presentation of HAE types 1 and 2 in pregnant and lactating females, including acute management, short-term prophylaxis, long-term prophylaxis, and drugs that should be avoided. Relevant publications were found through key word search of papers indexed in both Google Scholar and PubMed on 1 July 2022.
Treatment of HAE in the past has been mainly provided by experts; however, with more medications and an increasing number of patients, knowledge of how to care for HAE patients during pregnancy and lactation is important to review. Despite approval of additional medications in many countries, plasma-derived C1-inhibitor remains the drug of first choice for treatment in this unique population. Additional research is needed to increase safe access to other therapy options. We hope that future clinical studies, registries, and databases will shed additional light on this subject.
We presented a case of a 69-year-old woman who experienced monthly episodes of facial swelling and nonpruritic, erythematous rash on her face, accompanied by high fever, nausea, headache, and neck ...pain over 1 year. Her symptoms started with myalgia, arthralgia, fever and neck stiffness, and headache, and then angioedema occurred, which was painful to touch. She underwent multiple iatrogenic diagnostic and therapeutic procedures that did not lead to the correct diagnosis. Subsequently, relevant immunology laboratory tests were conducted after a careful history and physical examination, which led to the diagnosis. This case illustrated the need for a detailed history and thorough immunologic assessment, and the requirement to maintain a broad differential diagnosis.
Purpose of Review
Benign and malignant breast diseases in young, pregnant and lactating women including pregnancy associated breast cancers will be reviewed.
Recent Findings
Compared to breast cancer ...in older women, poor prognostic indicators such as high nuclear grade, high Ki67 proliferation, estrogen receptor (ER) negativity, and overexpression of human epidermal growth factor 2 (HER2) may be present in young women. Even among ER + /HER2 cancers, young patients have a poorer prognosis. For pregnant women, the timing of care may be personalized based on gestational age, tumor subtype, clinical stage, and family planning considerations, including induction of labor and preservation of fertility for future pregnancies. Neoadjuvant chemotherapy can be safely administered during the second and third trimesters, and if necessary, radiation therapy can be given after birth.
Summary
Symptomatic concerns warrant prompt imaging evaluation with biopsy to distinguish benign from malignant causes of breast disease in young, pregnant, and lactating women.
Current Status of Imaging for Breast Cancer Staging Pria, Hanna R. Ferreira Dalla; Scoggins, Marion E.; Moseley, Tanya W. ...
Current breast cancer reports,
06/2024, Letnik:
16, Številka:
2
Journal Article
Recenzirano
Purpose of Review
Breast cancer is the most common cancer among women. Accurate clinical staging is important as it guides management and treatment. The radiologist plays an important role in the ...evaluation of breast cancer because imaging is integral to clinical staging. This review aims to highlight the various aspects of staging breast cancer with an emphasis on the appropriate use of imaging.
Recent Findings
The 8th edition of the American Joint Commission on Cancer (AJCC) Staging Manual incorporates tumor markers and other prognostic factors, in addition to the traditional anatomic staging. This allows a more precise estimation of disease extent, allowing appropriate treatment and management of patients. Imaging plays an important role in accurately staging patients clinically. Different breast imaging modalities and systemic imaging modalities complement each other to give the most accurate clinical stage, which is then combined with biological and prognostic factors to guide patient management.
Summary
Understanding the staging of breast cancer is essential for the radiologist and allows for individualized and prognostic-based management of breast cancer patients.
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