Studies Have Proved the Benefits of Digital Breast Tomosynthesis: Now How Do We Change Referral Habits?

Dr. Harmindar Gill, Medical Director, Premier Women’s Radiology (Bonita Springs, Fla.)

Dr. Harmindar Gill, Medical Director, Premier Women’s Radiology (Bonita Springs, Fla.)

As a female radiologist, I have created a practice dedicated to women’s imaging that includes digital breast tomosynthesis (DBT), breast and body ultrasound, whole body bone density screening and other services. I also read breast MR images that are captured at another facility.

According to the American Cancer Society, 1 in 8 women will develop breast cancer during her lifetime—just over a decade ago the rate was 1 in 11 women. Genetics cannot account for this increase since 85 percent of breast cancer victims have no family history of the disease. There are a variety of factors that may be contributing to increased risk, including estrogen in our foods, post-menopausal hormone therapy and childbearing later in life. The good news is that the ACS reports death rates from breast cancer in the U.S. have dropped 34% since 1990.

I am an avid proponent of DBT because I believe it can assist in the effort to further reduce deaths from breast cancer. In my personal experience, I have found small lesions that I did not detect on other breast imaging exams and it also decreased the need to recall patients for additional testing. The ability for DBT to increase cancer detection rates and decrease recall rates has now been well documented through studies conducted across the country. In 2013 breast tomosynthesis captured attention and acceptance throughout the radiology community, as illustrated by the dozens of scientific presentations and poster sessions focused on DBT at RSNA 2013.

One RSNA 2013 presentation reported results from a study in which every patient since October 2011 was screened for breast cancer using DBT at Hospital of the University of Pennsylvania (HUP) in Philadelphia. The study’s lead author was Emily F. Conant, M.D., chief of breast imaging at HUP. Dr. Conant and five colleagues compared imaging results from 15,633 women who underwent DBT at HUP beginning in 2011 to those of 10,753 patients imaged with digital mammography the prior year. Six radiologists trained in DBT interpretation reviewed the images. The researchers found that compared to digital mammography:

  • Average recall rate using DBT decreased from 10.40 percent to 8.78 percent
  • Overall cancer detection rate increased from 3.51 to 5.25 (per 1,000 patients)
  • Overall positive predictive value for the group—the proportion of positive screening mammograms from which cancer was diagnosed—increased from 4.1 percent to 6.0 percent with DBT.

A prominent earlier study published in the June 2013 issue of the American Journal of Roentgenology documented the benefits of DBT by Dr. Stephen L. Rose and his colleagues at TOPS Comprehensive Breast Center of Houston, Texas. This study compared recall rates, biopsy rates, and cancer detection rates for six radiologists who interpreted 13,856 screening mammography studies without tomosynthesis and 9,499 studies with tomosynthesis.

For the group as a whole, the use of tomosynthesis resulted in:

  • Increase in invasive cancer detection rate from 2.8 to 4.3 per 1,000 screening examinations
  • Increased cancer detection rates from 4.0 to 5.4 per 1,000 screenings
  • A reduction in recall rates from 8.7% to 5.5%
  • Reduction in biopsy rates from 15.2 to 13.5 per 1,000 screenings.

As a result of my personal experience and the scientific studies now available, I advocate use of DBT for all screening mammograms—especially for patients with dense breasts, patients with BRCA gene mutation and those who have been previously diagnosed with breast cancer—because its three-dimensional imaging offers significantly enhanced visualization of breast tissue.

Now that we recognize the advantages offered by DBT, the challenge is to make tomosynthesis a mainstream screening protocol. It’s not enough for radiologists to recognize the value of tomosynthesis—physicians and gynecologists need to be educated about the benefits of this technology since these doctors account for a majority of the referrals for annual screenings and follow up exams.

Hear more about Dr. Gill’s practice and the importance of DBT below from RSNA 2013.

ACR on the CNBSS Mammography Study: “Deeply Flawed and Widely Discredited”

Clinical Development Manager, Women’s Healthcare, Carestream

Anne Richards, Clinical Development Manager, Women’s Healthcare, Carestream

A disturbing study about the effectiveness of mammography was released to the public on February 11 in the British Journal of Medicine. The New York Times wrote about the study, providing such summaries as:

“… the death rates from breast cancer and from all causes were the same in women who got mammograms and those who did not. And the screening had harms: One in five cancers found with mammography and treated was not a threat to the woman’s health and did not need treatment such as chemotherapy, surgery or radiation.” – New York Times, February 12, 2014

The goal behind this study was for researchers to determine if there is any advantage to discover breast cancers that were too small to feel. The study claimed that there is no advantage, but the American College of Radiology (ACR) came to the rescue to debunk this claim.

The ACR came right out to call the study “deeply flawed and widely discredited” and backed up its words. Citing reviews from experts, the ACR learned that the trial used second-hand mammography machines, which were not the most up-to-date at the time the study was conducted. The ACR went on to say:

“The images were compromised by ‘scatter’ which makes the images cloudy and cancers harder to see since they did not employ grids for much of the trial. Grids remove the scatter and make it easier to see cancers. Also, technologists were not taught proper positioning. As such, many women were not properly positioned in the machines, resulting in missed cancers. And the CNBSS radiologists had no specific training in mammographic interpretation.” – American College of Radiology, February 12, 2014

Additionally, the ACR brought about claims that the CNBSS violated the rules of conducting a randomized, controlled trial (RCT). This was because each woman who participated in the study had a clinical breast examination by a trained nurse so that they knew which women had lumps and which women indications of more advanced cancer. For a RCT to be valid, the women assigned to the screening group or the control group must be random, and this was certainly not the case.

One issue with the wording in the news articles that covered the CNBSS study is that they are including mammography exams into the same category as treatment. But these are two different areas. Mammography and the advancements made in the field are leading to earlier detection of breast cancer. Patients are then referred to their physicians who then determine the diagnosis best course for treatment.

Along with the ACR, the mammography medical community made sure its voice was heard after large news outlets began picking up the story. On the radiology trade publication site AuntMinnie, Dr. László Tabár and Tony Hsiu-Hsi Chen, DDS, PhD, wrote an op-ed about the CNBSS study and how the medical field has been dismissing it for years, citing it as being “a failure from the beginning.”

They go on to say that even the World Health Organization’s International Agency for Research on Cancer (IARC) workshop excluded the study in 2002 because the study was not population based and “the Canadian trials could not evaluate the independent impact of mammography because of the confounding effect of physical examination.” At the end of their letter, Drs. Tabár and Chen quote Dr. Norman Boyd, who had this to say about the CNBSS study 21 years ago in Radiology (1993, Vol. 189:3, pp. 661-663):

“Taken at face value, the results of the [CNBSS] argue for abandoning mammographic screening as a population-based means of controlling death rates from breast cancer. We believe such a conclusion to be unjustified and unsupported by the findings of the [CNBSS] … [and] the results of these trials should not be used to change the prevailing scientific view of the potential benefits of screening with mammography.”

Those of us that have been involved in mammography since the 70s have seen enormous advances in the understanding of what is needed to ensure early detection and the effectiveness of mammography. The industry has helped to improve the image quality since the Canadian study with advances in analog film, improvements in x-ray units and of course the introduction of digital mammography and digital breast tomosynthesis.  There have also been great advancements in the training of technologist that perform and the radiologists that interpret mammography.

Early detection remains a must if we wish to continue to improve the survival rate of breast cancer. To dismiss the value of mammograms is to turn a blind eye toward a disease that is predicted to be diagnosed in 232,670 new cases in 2014 in the United States alone (source: American Cancer Society). It is the second leading cause of cancer death in women and dismissing exams that can lead to earlier detection is putting more women at risk.

In the video below, Dr. Tabár provides more details about the flaws behind the the CNBSS study.

[youtube=http://www.youtube.com/watch?v=e9SnA9l0AT4&w=560&h=315]

Sizing Things Up

Marianne Matthews, Editor, Imaging Economics

Marianne Matthews, Editor, Imaging Economics

Guest post by Marianne Matthews, editor of Imaging Economics.

I had to chuckle recently when Jockey rolled out its new bra sizing system. Everyone from fashionistas to morning talk show hosts seemed obsessed with the news. It even garnered coverage (pardon the pun) on the front page of The New York Times. While some called the new bra sizing system important, others deemed it unnecessary and even downright confusing.

When it comes to their breasts, American women have a lot more important things to think about. And some of it—like understanding the real implications of breast density—can be as confusing as going from a 34B to a 7-36.

Although 10 states have now enacted breast density notification laws, the issue remains controversial. Proponents say it’s a no-brainer. They point to studies that show that increased breast density correlates with increased breast cancer risk. Experts say those with extremely dense breast tissue have twice the risk of breast cancer compared to those with average breast density. Moreover, dense breast tissue makes it hard to spot cancer on a mammogram.

So why not just enact legislation that mandates informing women of their density?

Well, there are a lot of reasons not to. Some of those opposed say the science is not perfect, density studies are misleading, and density alone is not necessarily a major cancer risk. Others fear the notification legislation will lead to too many tests and unnecessary biopsies. Still others object on principle to the government legislating medical care.

To be honest, I’ve had trouble sizing up the issue myself. Originally, I was all for notification legislation. Then, when I had a mammogram a few months ago, I talked to my radiologist. Turns out, she’s adamantly opposed to the density notification because she believes it will lead to “panic” among women. She’s not the only expert who feels density notification will only confuse women further, perhaps make them think they have cancer, or mistrust mammography altogether. She’s got a point. (There is a great deal of confusion among the highly educated women I know about breast density.)

So, I’ve gone round and round on the issue and come full circle. On balance, I think it’s a good thing. At this point, I see at least three simple reasons to support density notification laws.

First, in today’s society, patients are expected to be their own advocates—and doctors have pretty much made that the case. Doctors spend very little time in office visits actually communicating with patients. We’re expected to arrive prepared with our list of complaints and questions—and cover them all in less than 10 minutes. We’re expected to know our numbers. In some cases, we’re even forced to follow up on test results because all too often the physician’s office doesn’t bother to call with results. So, since we’re expected to be sophisticated patients—which takes some of the burden off of doctors—we need to be informed about our own bodies. That’s as good a reason as any to let women know if they have dense breasts.

Second, there is no turning back. Advocacy organizations are succeeding on Capitol Hill. In addition to the 10 states that already have density notification laws on the books, several more state legislatures have introduced legislation in 2013. What’s more, Federal legislation is under way. My point: You can’t put the genie back in the bottle.

Finally, as a radiologist, if you come out against density notification, you’re probably shooting yourself in the foot. Though I remain loyal to my breast imager, my guess is most women would not find her views all that favorable. In short, it’s politically incorrect for a women’s imaging provider to oppose the density movement.

So, you might as well use the density issue as an opportunity to educate your patients. Talk to her; get closer to her; show her radiology’s value. You can either be viewed as a foe or join the fight. That’s about the size of it.

Dragon Boat Racing Offers Breast Cancer Survivors a New Way to Get Fit While Building Comradery

Cristine Kao

Cristine Kao, Global Marketing Manager, Healthcare IT, Carestream

Breast cancer survivors have joined together in an activity that focuses on support, wellness and competition as way to recover from breast cancer. The diagnosis of breast cancer has brought survivors from around the world together in the unique paddling sport of dragon boating.

Paddling in colorful dragon boats offers an active, health-giving, life-affirming option for breast cancer survivors. Dragon boat racing is a relatively new but rapidly growing international activity. A dragon boat is a long, colorful wooden or fiberglass boat adorned with a dragon head at the front and tail at the back — with room for about 20 paddlers and a drummer. Teams of cancer survivors and their supporters paddle in harmony to the beat of a drum. The sport of dragon boating provides the benefit of vigorous exercise and may help prevent or relieve the symptoms of lymphedema — a common side effect from the effects of breast surgery or radiation.

I recently had the opportunity to coach a group of breast cancer survivors from the Dragonheart Vermont club that plans to send a crew to the U.S. National Championship in September. These contestants will compete to win a chance to represent the U.S. at the 2014 Club Crew World Championships in Ravenna, Italy. The championship has a division for breast cancer survivors and it’s estimated that there are about hundreds of dragon boat breast cancer teams around the world.

Cancer research and treatment has made dramatic strides in the last 10 years. Thousands of activities publicize the ability for survivors to recover from this previously debilitating disease and live normal, active lives. However more research is needed, which is why we all need to support additional research to develop new detection methods and treatments for all forms of cancer.

Please visit the International Breast Cancer Paddlers Commission if you would like to get involved with a local team. The rewards are many!

We would like to hear comments from readers who have participated in these types of events. When did you first hear about dragon boat races and what benefits have you received from being on a dragon boat team?

Dragon Boat Team

Dragon Boat Team

RSNA ’12 Preview: Digital Breast Tomosynthesis and PACS Integration

Anne Richards, Carestream

Anne Richards, Clinical Development Manager, Women’s Healthcare, Carestream

When RSNA opens on Sunday, we can expect digital breast tomosynthesis (DBT) to dominate the attention of providers and radiologists interested in women’s imaging. A scan of the scientific and educational sessions featured in AuntMinnie’s “Road to RSNA 2012: Women’s Imaging Preview” highlights the early evidence of increased cancer detection and lower recall rates, which is driving interest in DBT in spite of lingering questions about reimbursement.

For providers who have adopted or on the cusp of offering DBT, however, we expect the discussions in the exhibit halls to extend beyond potential clinical benefits to the IT considerations raised by DBT early adopters. For example, DiagnosticImaging.com reported earlier this Spring on a KLAS report that highlighted the PACS integration challenges of DBT:
“Doctors are reporting interruptions in their day because not all PACS accept tomosynthesis studies. “It has created a workflow concern for radiologists who have to leave their office or reading room and come out to the tomosynthesis workstation to read the study,” said Monique Rasband, author of the report, Women’s Imaging 2012: Tomosynthesis Makes a Splash.” The doctors do say, however, that this extra time seems worth the effort because of the procedure’s effectiveness, she said.
While capturing the best breast images possible is important, it is just one piece of the care continuum. For DBT to succeed the reading environment must help radiologists make a fast, accurate diagnosis with minimal disruption to the diagnostic workflow.

 

At RSNA, we’ll be demonstrating our Digital Breast Tomosynthesis (DBT) Module for our CARESTREAM Vue Mammo Workstation that lets radiologists read all procedures from a single desktop. The workstation displays digital breast tomosynthesis studies, traditional mammograms, breast ultrasound, breast MRI and general radiology exams to help equip radiologists to work efficiently from a single desktop.

 

Here a quick video overview of how it works:

Comparison tools enable radiologists to use personalized hanging protocols for DBT exams along with other procedures. Specialized tools can further enhance productive reading: automatic positioning of DBT and mammograms eliminates manual manipulations; automatic “same sizing” of DBT and mammograms aid in comparing changes in anatomy; and concurrent magnifying glasses provided close-up comparison of pathology across multiple views and procedures. DBT exams can be viewed in cine mode or by scrolling.

If digital breast tomosynthesis is on your agenda at RSNA, swing by the Carestream booth (#2636) to get hands on with our DBT module or schedule your appointment now. 

Reading Digital Breast Tomosynthesis Exams From a Single Desktop

Anne Richards, Carestream

Anne Richards, Clinical Development Manager, Women’s Healthcare, Carestream

A recent article in the Wall Street Journal on 3-D mammography discussed the potential for digital breast tomosynthesis (DBT) to enhance the detection of cancers. I was reminded of how important it is to not only capture the best breast images possible, but also to have an efficient and effective system that helps radiologists make an accurate diagnosis.

As I revisited the accomplishments our team has achieved in designing a new module that displays DBT exams on our mammography workstation—while also displaying digital mammograms, breast ultrasound, breast MRI and general radiology exams from a single desktop—I was struck by how easy it is (or could have been) to add yet another dedicated workstation to the radiology reading environment and then falsely believe we have actually improved the diagnostic workflow.

We resisted that path. Our team has long demonstrated our commitment to supporting multiple digital breast imaging modalities on our mammography workstations, and we have fiercely resisted the temptation add new, single-use workstations that might seem alluring because of their “dedicated” nature—when in fact they add costs and create inefficiency. Supporting multiple breast imaging modalities—as well as general radiology exams—enables radiologists to deliver a faster diagnosis to referring physicians and can ultimately enhance patient care.

Our smartly designed tomosynthesis module streamlines workflow by allowing healthcare providers to store, route, display and query/retrieve DBT exams from DICOM-compliant acquisition devices, so radiologists have all the tools they need on one workstation. Comparison tools enable radiologists to use personalized hanging protocols for DBT exams along with other procedures, especially the 2D mammograms. In addition, specialized tools that further enhance productivity include: automatic positioning of DBT and mammograms that eliminates manual manipulations; automatic “same sizing” of DBT and mammograms that aid in comparing changes in anatomy; and concurrent magnifying glasses that provide close-up comparison of pathology across multiple views and procedures.

With our advanced sys­tem, radiologists can quickly and easily read exams from all modalities and vendors at a single workstation. And working smart is an important element in improving patient care.

How do you view or plan to view digital breast tomosynthesis? What do you think about 3D breast imaging?

For Mammography Tech Technology Has Changed Everything

Sherri Ford, RT(R)(M)(BD)

Editor’s Note: Sherri Ford is a Mammography Technologist at Premier Imaging in High Point, NC.  She has her A.A.S. degree in Radiological Technology and a B.S. in Health Administration.  She has over 19 years experience in the mammography field ranging from mammo-screenings, diagnostics, stereo biopsies and needle localizations.  She has worked as a PACS systems supervisor and has designed training programs for occupational nurses regarding osteoporosis and bone density testing.  Sherri is also a member of ACR, ASRT and HIMSS.

Q: You have a varied experience as a technologist from a PACs supervisor to mammography.  What are the major changes you have seen in the mammography workflow?

A: Technology changes everything. While technology is almost always eagerly awaited in mammography facilities, implementing new machinery often results in workflow growing pains. When digital mammography was introduced several years ago, facilities frequently floundered, causing workflow to slow down. The past five years has seen department workflow changes as processes were perfected, allowing more patients per hour. Many facilities have moved to a paperless system further speeding up workflow. As technologists, we have had to learn how to manage exam times, review images for technical quality in a new medium and not lose sight of the fact that our patients are individuals with feelings. Technology creates efficiency, confidence in the screening process and improved image quality but the equipment is costly. To offset the increased costs, schedules are packed tight and patients are streamlined from registration to exam result. Over the past several years, the most noticeable change in mammography workflow is undoubtedly the rapid pace. While increased volumes are a positive trend, indicating women are committed to the fight against breast cancer and health administrators are committed to providing the services, technologists must balance efficiency and compassion.

Q: Has the economic situation over the last few years impacted how you do mammography?

A:  Healthcare was one of the last industries to respond to the economic crisis and is one of the last industries to recover as economic conditions slowly improve. When unemployment peaked many lost their health insurance but not their need for healthcare. Health organizations were faced with the problem of meeting level or increased demand for services with severely diminished revenue streams. Mammography tends to be a loss leader for many health organizations to begin with and the downturn in the economy hit just on the heels of acquiring new digital equipment, further compounding financial challenges. Most mammography centers responded to the conditions by increasing volumes and reducing payroll hours to address cost control but savvy administrators marketed the services to attract new mammography patients and retain the existing ones. Programs became available to provide low or no cost mammograms with the expectation these patients would be a source of referrals, sending new patients to the organization for other health needs.

Q: Do women have specific requests for technology they have heard about and if so what are they asking for?

A:  Breast cancer screening relies most heavily on mammography primarily because the system has proven to be successful, accessible and cost efficient. However, mammography does not find all cancers and research continues to find new methods for screening and diagnosis. Periodically, patients will hear or read about new technologies and ask if they are available. Most of the time, patients will ask me about screening methods that do not require compression but rarely mention specific technologies. As healthcare becomes more transparent, however, this may change because the public will have greater access to information about diagnostic testing. Also, patient requests for new technology increase when it is introduced into the community.

Q:   Is your facility doing digital breast tomosynthesis?

A: With the recent FDA approval of Breast tomosynthesis, breast cancer screening has a remarkable new tool to aid in earlier detection, especially in women with dense tissue. Despite the success stories tomo has produced, it is not widely utilized in the US yet. Health insurance does not reimburse for tomo exams at this time, considering the technology investigational and many facilities cannot absorb the cost. Some facilities pass the cost on to the patient as an up charge to a mammogram, usually offering the patient the option of having the tomo and paying or declining the exam. I recently had the opportunity to observe several tomo exams and believe this technology will become the industry standard for screening. My facility is not currently offering tomo but is evaluating the technology. Breast tomo offers new possibilities in breast cancer screenings and should be embraced with excitement and anticipation.

Researchers Favor Annual Mammograms With No Family History

Stamatia Destounis, MD, FACR

Stamatia Destounis, MD, FACR, Elizabeth Wende Breast Care

Editor’s note:  Doctors at the Elizabeth Wende Breast Care in Rochester NY recently presented a study in Vancouver on breast cancer risk factors in women under 40.  Stamatia Destounis, MD, FACR, the study presenter at the ARRS annual meeting in Vancouver, answers three quick questions about the study’s reception and the continuing breast screening controversy.

Q:  At the American Roentgen Ray Society Annual Meeting you presented your finding on the ideal age for women to begin screening mammograms and the appropriate intervals between screenings. How were your findings received at the conference?

A: There was interest and enthusiasm at our results which revealed that women in their 40’s with no family history of breast cancer benefit from having a yearly screening mammogram, as a considerable number of the cancers diagnosed in this age group were through screening mammography, and 64% of these women had invasive breast cancers with 26% of these having metastatic lymph nodes. These are cancers that need to be found and can’t wait for women to be fifty before starting to have a screening program.  Controversial recommendations from some Organizations have recently argued that women in their 40’s don’t need screening mammography until they are 50 and our data do not agree with them at all.
Q: The screening debate seems to have new twists and turns often. For physicians speaking with confused patients, how would you recommend guiding the discussion?

A: Most women don’t have a family history of beast cancer when they are diagnosed with breast cancer. We believe that a screening mammogram yearly starting at age 40 saves lives as many well organized and regulated trials have revealed in the last 20-30 years. We recommend a yearly mammogram for women in their 40’s and our own review just presented in Vancouver revealed that a considerable number of women in their 40’s with no family history of breast cancer were diagnosed with a screening mammogram, revealing approximately two thirds of these patients having invasive breast cancer and a third with metastatic breast cancer.

CARESTREAM Vue Mammo Workstation

Q: Do you feel the screening debate is harmful to women’s health? Has the media attention impacted screening rates?

A: I think women and their health care professionals are getting confused by the controversy surrounding screening mammography and the constant media frenzy with controversial and conflicting analyses, data collections and personal opinions. There are many opinions, and emotion regarding breast cancer and this adds to the continued controversy.

The future of breast imaging is in the making.

Anne Richards, Carestream

Anne Richards, Clinical Development Manager, Women’s Healthcare, Carestream

Q: Are you seeing more young radiologists going into mammography services? 

A: At mammography conferences and continuing education courses around the world, I’ve been seeing younger participants than in the past. In fact, I’d say that more than half of the radiologists attending a recent seminar in Brazil were under the age of 40.

This is a great trend for the future of our field!

Historically, breast imaging in general—and mammography in particular—has been viewed as a difficult and unglamorous vocation.

It involved the monotonous task of looking at primarily normal images. It has been characterized by a high rate of recalls and retakes, as well as low reimbursement and higher risk of litigation. Compared to interventional radiology and other specialties, it just didn’t have the “wow” drawing power.

So what is attracting today’s up-and-coming radiologists to this area of specialty?

The multi-modality nature of breast imaging may be part of the answer, with mammography, ultrasound, MRI, and molecular imaging being used in tandem for screening and diagnosis. In addition, advances in digital technology are making this a cutting-edge discipline with appeal for younger medical school graduates.

Beyond just the technology, though, there is the point on which we all can agree: screening mammography saves lives. And saving lives is a strong motivator for anyone in the field of medicine.

If you have an open fellowship in breast imaging, let me know. Together, let’s do all that we can to encourage these future luminaries in the making.

What motivated you to go into the field of breast imaging? Who supported you in your efforts?

Annual National Interdisciplinary Breast Center Conference Stresses “Self-Care” and Continued Education

Julia, Weidman, Marketing Manager, Women's Health & Healthcare Information Solutions, Carestream

The 22nd Annual National Interdisciplinary Breast Center Conference sponsored by the National Consortium of Breast Centers opened yesterday in Las Vegas.

A global audience of nearly 1,000 attendees will participate in more than 120 sessions from 78 world-class presenters focused on the clinical, imaging, administrative and nursing concerns associated with breast health and breast center management.

The celebrity keynote was given by Kelly Corrigan. The New York Times best-selling author talked frankly and engagingly about her battle with breast cancer, and what compelled her to author her book “The Middle Place.”  Ms. Corrigan spoke about the strong bonds she developed with the caregivers who helped her navigate her journey – “the magic we”, and encouraged attendees to “perform the role nobly”.

Elizabeth Clark PhD, ACSW, MPH, executive director of the National Association of Social Workers, delivered the professional keynote “Words that Heal, Words that Harm.”  Ms. Clark raised attendees’ awareness of the context of the words they use, and how powerfully those words impact patients.  Ms. Clark also spoke about the importance of creating communities of hope for cancer patients and the need for caregivers to practice “self-care” to avoid burnout.

Visitors to the Carestream booth shared feedback that this year’s conference featured a nice blend of technology and experience sharing:

“We hear from the best and brightest in the field at this meeting.The multidisciplinary study tracks and discussions about emerging technologies are real learning experiences,” said Bonnie Rush RT (R) (M) (QM) from Breast Imaging Specialists.

Deb Wright, President and CEO of Inner Images was a judge for the poster session:

“Tech-wise there was a lot of molecular imaging. And I was glad to see papers on outreach programs for survivors.”

Dr. Lazlo Tabar commented, “This year’s NCBC has a very interesting program, very comprehensive both for physicians, technologists and nurses.” Dr Tabar also spoke about the sessions he and and Louise Miller RT (R) (M) will hold for technologists focusing on the proper positioning of the breast in screening:

“The radiology technologist is a very important part of the diagnostic team.  They are responsible for proper positioning.”

We’re sure the technologists here at the conference will line up early to get a seat!

Other hot topics like healthcare reform, breast density issues, risk assessment and geonomics and tomosynthesis will be covered throughout the conference, which ends on Wednesday. You can follow the conversation from the conference on Twitter using the hashtag #NCOBC.