A big week in breast imaging

A trio of studies this week highlighted progress and pitfalls in breast imaging. On the positive side, research detailed the potential of breast tomosynthesis and suggested that mammography may play a role in monitoring therapy. Much less heartening was the finding that young women with breast cancer who are poor, African American, Hispanic or uninsured face delays in treatment that appear to impact outcomes.

An integrated 2D and 3D mammography screening protocol demonstrated that the combined approach outperformed 2D alone, with the integrated model detecting 8.1 cancers per 1,000 screens vs. 5.3 per 1,000 with the 2D approach, according to a study published online April 24 in The Lancet Oncology.

In addition, the researchers estimated that applying a conditional rule requiring positive 2D and 3D exams as a condition for recall could have reduced false-positive recall exams.

Mammography may pull double duty in other ways as well. The exam could play a role in monitoring tamoxifen therapy as women whose breast tissue density decreased via mammography halved their risk of death from breast cancer, according to a study published online April 22 in the Journal of Clinical Oncology.

As research demonstrated imaging’s prowess, other information documented disparities in the breast cancer treatment process. Specifically, although the mean delay between diagnosis and treatment was 2.7 weeks, more African-American, Hispanic and low socioeconomic status women encountered delays of six weeks or longer than their high socioeconomic peers. Women who faced these delays had lower survival rates, according to the study published April 24 in JAMA Surgery.

Other top stories of the week detected shortcomings in physicians’ performance.

A mathematical prediction model outperformed radiation oncologists in predicting the outcome and responses of lung cancer patients to treatment.

And a blog post in General Surgery News spoofed the lack of clarity in some radiology reports.

I hope this Friday finds you well, and that our news coverage has provided useful information. Please email me with your thoughts and suggestions.

Lisa Fratt, editor