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Steps in Editing Breast Imaging Patient History Form on Windows

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PDF Editor FAQ

Is ABVS ultrasound better at detecting abnormal tissues in breasts than conventional ultrasound? I heard that, in one doctors’ opinion, ABVS ultrasound has high radiation. Is it true?

First, the doctor that told you about the radiation with ultrasound is dead wrong. Automated whole breast ultrasound (ABUS) is also referred to as automated breast volume scanner (ABVS). They are essentially the same thing but different manufacturers of the equipment like to distinguish their products and techniques. Both are forms of ultrasound and have no ionizing radiation at all. Zero. Period.Now that that's out of the way, ultrasound of the breast has recently been shown to be useful in detecting some cancers that mammography may not show.Note, please keep in mind there are many cancers that will definitely not show up on breast ultrasound and therefore screening for breast cancer with ultrasound alone should never be done because cancers will definitely be missed.While ultrasound can be useful for screening for breast cancer, one problem with the traditional method (ultrasound tech or doctor holds probe in hand and moves it around to loook at the breast tissue) is that it can take a long time. Many complete and thorough exams can take 30 minutes or even an hour depending on the size of the breast, complexity of breast tissue, and experience of the ultrasound technologist or doctor.Another problem with the traditional ultrasound method is that the quality of the exam completely depends on the ability of the ultrasound technologist or doctor. Some people are good at it, some are not. I have seen large cancers completely missed after 30 minutes of scanning only to be found 30 seconds later by a different technologist or physician coming behind to re-scan the patient.ABUS/ABVS makes the traditional ultrasound more reliable and shorter. While it cannot replace (and in many aspects will never be as good as the expert performing the traditional ultrasound), it makes using ultrasound to screen for breast cancer more realistically feasible in today's world.So should everyone be screened with automated breast ultrasound AND mammography? The answer as of now (according to best practice in line with what the research has shown) is ‘NO’. While it is true that more cancer will be detected, the one problem with screening breast ultrasound is that it picks up many abnormal appearing areas in the breast that do not turn out to be breast cancer. In other words, it's very likely that ultrasound will find something in the breast that needs to be biopsied because of the way it looks, but it turns out NOT to be breast cancer.As of now, the benefit of the extra cancer detection from screening with ultrasound only seems to outweigh the risks of biopsy for patients that have a higher risk for breast cancer such as strong family history or dense breast tissue.Anyone concerned of the above should talk with their primary care doctor.—Ryan Polselli, MD, Diplomate of the American Board of Radiology, Fellowship Trained Breast Imaging Radiologist.

What do doctors think of patients who Google their symptoms?

Googling symptoms has become an inside joke among everyone who’s done it (which is most of us!) Every possible symptom can be associated with a scary, life-threatening condition and a Google search can do little to inform patients about the right next step for their personal situation. But I (and I think most doctors) welcome patients to take control of their health. I completely understand the reflex to whip out your phone or hop online for a quick search – and in reality, patients have a legitimate need for quick and discreet information when it comes to timely health issues and anxieties. The internet is a useful tool for reading about medical conditions but is less useful for diagnosis and treatment. For example, I searched “right breast pain” and saw a plethora of responses all of which were associated with the breast cancer, but breast pain may also be caused by gallstones. Clinicians can analyze this information by taking a detailed medical history.As a doctor, of course I hope my patients come directly to me for definitive answers, not only as an expert source, but because I understand the components that create the clinical picture. I know what questions to ask (Is the right breast pain exacerbated by eating fried food , etc.?). I can perform a targeted physical exam and order labs/imaging study, as needed, and interpret all of this data to form a diagnosis and treatment plan. With an increase in hospitals and health systems using remote technology, either on the phone or online chat, there are lots of options to reach your doctor quickly.Use Google search with healthy skepticism, and take that information to your doctor to apply it to your whole-picture health. The best resources for finding reliable information on medical conditions are medical societies such as the American College of Ob/GYN, the American Academy of Dermatology, and the American Academy of Family Physicians, as well as government websites, e.g., Center for Disease Control and the National Institutes of Health.

Why does my mammogram show lymphadenopathy after having gotten a covid vaccine (Pfizer) 5 weeks before?

Hello Angelita - take a deep breath and relax just a bit, because there are a lot of women who are having the same experience right now.It has been recognized and publicly acknowledged that recent Covid-19 vaccination can lead to some false positives on mammography images. Here are a few articles that you may find reassuring - from Johns Hopkins Medicine[1], MD Anderson Cancer Center[2] at the University of Texas, and University Hospitals[3]in Ohio.Lymph nodes are part of the body’s immune system, and so are activated by a vaccine being introduced. This increased level of activity - which causes the nodes to become larger, denser and sometimes tender to touch - is normal while the body is building immunity. The higher than usual prevalence of visible lymph nodes on mammograms during this time of mass immunization has lead the Society of Breast Imaging[4] to issue updated recommendations around breast screening.Their current guidelines may be read in entirety here ,[5] but the bulleted points for consideration are:Consider obtaining the following information on patient intake forms: COVID-19 vaccination status, timing and side (left vs. right arm) of vaccination. To minimize patient anxiety, consider including this introductory statement: Vaccines of all types can result in temporary swelling of the lymph nodes, which may be a sign that the body is making antibodies in response as intended.Unilateral axillary adenopathy on screening exams warrants a BI-RADS category 0 assessment to allow for further assessment of the ipsilateral breast and documentation of medical history, including COVID-19 vaccination.Following appropriate diagnostic work up for unilateral axillary adenopathy in women who received a COVID-19 vaccination in the ipsilateral upper extremity within the preceding 4 weeks, consider a short term follow up exam in 4-12 weeks (BI-RADS category 3) following the second vaccine dose.If axillary adenopathy persists after short term follow up, then consider lymph node sampling to exclude breast and non-breast malignancyFor women who have not yet scheduled a screening mammogram, the current advice is: “ If possible, and when it does not unduly delay care, consider scheduling screening exams prior to the first dose of a COVID-19 vaccination or 4-6 weeks following the second dose of a COVID-19 vaccination.”Being fully immunized for Covid-19 is important, and routine mammography screening is equally important. We are highly intelligent beings, able to walk and chew gum at the same time - so it stands to reason that we will be able to manage these two aspects of healthcare at the same time!Best wishes for your good health and happiness!Footnotes[1] Covid-19 Story Tip: Guidelines for Timing of Mammograms and Receiving a COVID-19 Vaccine[2] COVID-19 vaccines and mammograms: 7 things to know[3] Mammogram May Show Swollen Lymph Nodes From COVID-19 Vaccine[4] Society of Breast Imaging > HomePage[5]

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