Breast cancer risk factors in relation to breast density (United States)

OBJECTIVES: Evaluate known breast cancer risk factors in relation to breast density. METHODS: We examined factors in relation to breast density in 144,018 New Hampshire (NH) women with at least one mammogram recorded in a statewide mammography registry. Mammographic breast density was measured by radiologists using the BI-RADS classification; risk factors of interest were obtained from patient intake forms and questionnaires. RESULTS: Initial analyses showed a strong inverse influence of age and body mass index (BMI) on breast density. In addition, women with late age at menarche, late age at first birth, premenopausal women, and those currently using hormone therapy (HT) tended to have higher breast density, while those with greater parity tended to have less dense breasts. Analyses stratified on age and BMI suggested interactions, which were formally assessed in a multivariable model. The impact of current HT use, relative to nonuse, differed across age groups, with an inverse association in younger women, and a positive association in older women (p < 0.0001 for the interaction). The positive effects of age at menarche and age at first birth, and the inverse influence of parity were less apparent in women with low BMI than in those with high BMI (p = 0.04, p < 0.0001 and p = 0.01, respectively, for the interactions). We also noted stronger positive effects for age at first birth in postmenopausal women (p = 0.004 for the interaction). The multivariable model indicated a slight positive influence of family history of breast cancer. CONCLUSIONS: The influence of age at menarche and reproductive factors on breast density is less evident in women with high BMI. Density is reduced in young women using HT, but increased in HT users of age 50 or more

Supporting Our Team Through Creating Awareness: The Society of Radiologists in Ultrasound Sonographer Relations Committee Response to the 2016 Society of Diagnostic Medical Sonography Consensus Conference on Work Related Musculoskeletal Disorders

Musculoskeletal injuries have been and remain a significant issue for sonographers. Despite its importance, the topic of musculoskeletal injury in sonographers has received little attention in the radiology literature. Our goal is to bring this extremely important issue to the forefront, with the hope of initiating conversations and actions leading to improved workplace practices for sonographers

Reasons symptomatic breast cancer patients delay seeking medical care

Aim: To assess for factors contributing to the total delay in care, and specifically the behavioral delay-interval portion of that delay, experienced by a group of symptomatic breast cancer patients.Methods: This retrospective cohort pilot study included 24 females greater than 40 years-old with symptomatic breast cancer at time of diagnosis (including palpable mass, breast pain, other pain, discharge, nipple inversion). Participants were asked demographic information, as well as to identify, from a predefined list of options, the three most relevant causes for their delayed breast cancer diagnosis. Data sources included electronic medical record query and phone surveys.Results: Overall, 21/24 of our study’s participants identified at least one of our predetermined barriers to care as relevant to their cause for delay. The most commonly identified reasons for delay were health system utilization factors contributing to behavioral delay, including dependents/pressing matters, employment responsibilities, transportation costs and difficulty, fear of being judged by healthcare workers, and fear of not being able to afford treatment.Conclusion: Women with breast cancer can experience delays to eventual diagnosis and treatment during various timeintervals between first noticing a symptom and finally presenting to medical attention. This study provides evidence that one such possible interval is the behavioral delay interval. Health system utilization factors, psychological factors, demographic factors and help-seeking habits can contribute to an increased behavioral delay interval. Further research is warranted to address these factors and minimize their impact on patient care delivery

A succinct rating scale for radiology report quality

Context: Poorly written radiology reports are common among residents and are a significant challenge for radiology education. While training may improve report quality, a professionally developed reliable and valid scale to measure report quality does not exist. Objectives: To develop a measurement tool for report quality, the quality of report scale, with rigorous validation through empirical data. Methods: A research team of an experienced psychometrician and six senior radiologists conducted qualitative and quantitative studies. Five items were identified for the quality of report scale, each measuring a distinct aspect of report quality. Two dedicated training sessions were designed and implemented to help residents generate high-quality reports. In a blinded fashion, the quality of report scale was applied to 804 randomly selected reports issued before (n = 403) and after (n = 401) training. Full-scale psychometrical assessments were implemented onto the quality of report scale’s item- and scale-scores from the reports. The quality of report scale scores were correlated with report professionalism and attendings’ preference and were compared pre-/post-training. Results: The quality of report scale showed sound psychometrical properties, with high validity and reliability. Reports with higher quality of report scale score were more professional and preferable by attendings. Training improved the quality of report scale score, empirically validating the quality of report scale further. Conclusion: While succinct and practitioner friendly, the quality of report scale is a reliable and valid measure of radiology report quality and has the potential to be easily adapted to other fields such as pathology, where similar training would be beneficial