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Article ; Online: Managing Challenging Patient Interactions in Breast Imaging.

Soo, Mary Scott / Lowell, Dorothy A / Destounis, Stamatia V

Journal of breast imaging

2024 Volume 4, Issue 2, Page(s) 183–191

Abstract: Managing challenging patient interactions can be a daily stressor for breast imaging radiologists, leading to burnout. This article offers communication and behavioral practices for radiologists that help reduce radiologists' stress during these ... ...

Abstract	Managing challenging patient interactions can be a daily stressor for breast imaging radiologists, leading to burnout. This article offers communication and behavioral practices for radiologists that help reduce radiologists' stress during these encounters. Patient scenarios viewed as difficult can vary among radiologists. Radiologists' awareness of their own physical, mental, and emotional states, along with skillful communications, can be cultivated to navigate these interactions and enhance resiliency. Understanding underlying causes of patients' emotional reactions, denial, and anger helps foster empathy and compassion during discussions. When exposed to extremely disruptive, angry, or racially abusive patients, having pre-existing institutional policies to address these behaviors helps direct appropriate responses and guide subsequent actions. These extreme behaviors may catch breast imaging radiologists off guard yet have potentially significant consequences. Rehearsing scripted responses before encounters can help breast imaging radiologists maintain composure in the moment, responding in a calm, nonjudgmental manner, and most effectively contributing to service recovery. However, when challenging patient encounters do trigger difficult emotions in breast imaging radiologists, debriefing with colleagues afterwards and naming the emotion can help the radiologists process their feelings to regain focus for performing clinical duties.
Language	English
Publishing date	2024-02-29
Publishing country	United States
Document type	Journal Article
ISSN	2631-6129
ISSN (online)	2631-6129
DOI	10.1093/jbi/wbab089
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Molecular Subtypes of Breast Cancer: A Review for Breast Radiologists.

Johnson, Karen S / Conant, Emily F / Soo, Mary Scott

Journal of breast imaging

2024 Volume 3, Issue 1, Page(s) 12–24

Abstract: Gene expression profiling has reshaped our understanding of breast cancer by identifying four molecular subtypes: (1) luminal A, (2) luminal B, (3) human epidermal growth factor receptor 2 (HER2)-enriched, and (4) basal-like, which have critical ... ...

Abstract	Gene expression profiling has reshaped our understanding of breast cancer by identifying four molecular subtypes: (1) luminal A, (2) luminal B, (3) human epidermal growth factor receptor 2 (HER2)-enriched, and (4) basal-like, which have critical differences in incidence, response to treatment, disease progression, survival, and imaging features. Luminal tumors are most common (60%-70%), characterized by estrogen receptor (ER) expression. Luminal A tumors have the best prognosis of all subtypes, whereas patients with luminal B tumors have significantly shorter overall and disease-free survival. Distinguishing between these tumors is important because luminal B tumors require more aggressive treatment. Both commonly present as irregular masses without associated calcifications at mammography; however, luminal B tumors more commonly demonstrate axillary involvement at diagnosis. HER2-enriched tumors are characterized by overexpression of the HER2 oncogene and low-to-absent ER expression. HER2+ disease carries a poor prognosis, but the development of anti-HER2 therapies has greatly improved outcomes for women with HER2+ breast cancer. HER2+ tumors most commonly present as spiculated masses with pleomorphic calcifications or as calcifications alone. Basal-like cancers (15% of all invasive breast cancers) predominate among "triple negative" cancers, which lack ER, progesterone receptor (PR), and HER2 expression. Basal-like cancers are frequently high-grade, large at diagnosis, with high rates of recurrence. Although imaging commonly reveals irregular masses with ill-defined or spiculated margins, some circumscribed basal-like tumors can be mistaken for benign lesions. Incorporating biomarker data (histologic grade, ER/PR/HER2 status, and multigene assays) into classic anatomic tumor, node, metastasis (TNM) staging can better inform clinical management of this heterogeneous disease.
Language	English
Publishing date	2024-02-29
Publishing country	United States
Document type	Journal Article
ISSN	2631-6129
ISSN (online)	2631-6129
DOI	10.1093/jbi/wbaa110
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Article ; Online: Optimizing the Patient Experience during Breast Biopsy.

Soo, Mary Scott / Shelby, Rebecca A / Johnson, Karen S

Journal of breast imaging

2024 Volume 1, Issue 2, Page(s) 131–138

Abstract: For years, breast imaging has been the model in radiology for patient communication, and more recently, it has been a leader in the growing patient- and family-centered approach to care. To maintain high levels of patient satisfaction during image-guided ...

Abstract	For years, breast imaging has been the model in radiology for patient communication, and more recently, it has been a leader in the growing patient- and family-centered approach to care. To maintain high levels of patient satisfaction during image-guided core-needle breast biopsies, the radiologist should understand patient perspectives so that interventions can be developed to manage patient concerns. This article reviews patient perspectives before, during, and after imaging-guided breast biopsies, and it describes strategies to help optimize the experiences of patients as they navigate the process.
Language	English
Publishing date	2024-02-29
Publishing country	United States
Document type	Journal Article
ISSN	2631-6129
ISSN (online)	2631-6129
DOI	10.1093/jbi/wbz001
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Article ; Online: Response by Authors to Comments on Aminololama-Shakeri et al, "Screening Guidelines and Supplemental Screening Tools: Assessment of the Adequacy of Patient-Provider Discussion".

Aminololama-Shakeri, Shadi / Soo, Mary Scott / Grimm, Lars J / Destounis, Stamatia

Journal of breast imaging

2024 Volume 1, Issue 4, Page(s) 277

Language	English
Publishing date	2024-02-29
Publishing country	United States
Document type	Journal Article
ISSN	2631-6129
ISSN (online)	2631-6129
DOI	10.1093/jbi/wbz070
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Article ; Online: Screening Guidelines and Supplemental Screening Tools: Assessment of the Adequacy of Patient-Provider Discussions.

Aminololama-Shakeri, Shadi / Soo, Mary Scott / Grimm, Lars J / Destounis, Stamatia

Journal of breast imaging

2024 Volume 1, Issue 2, Page(s) 109–114

Abstract: Purpose: To assess breast imaging radiologists' perceptions of the adequacy of provider-patient discussions regarding the benefits and risks of screening mammography and supplemental screening in women with elevated risk and dense breasts.: Methods: ... ...

Abstract	Purpose: To assess breast imaging radiologists' perceptions of the adequacy of provider-patient discussions regarding the benefits and risks of screening mammography and supplemental screening in women with elevated risk and dense breasts. Methods: A 36-item questionnaire developed by the Society of Breast Imaging Patient Care and Delivery Task Force was distributed electronically to Society of Breast Imaging members to evaluate patient communication, education, and screening practices. Data from the 11 items specifically pertaining to screening practices were analyzed. Results: The response rate was 14% (275/1992). Seventy-four percent of survey respondents perceived provider-patient discussions regarding mammography screening guidelines as inadequate, and they agreed that provider-patient discussions regarding screening guidelines (82%) and supplemental screening for increased breast density (74%) should be standardized. Only 38% indicated that mammography screening guidelines are officially endorsed by their institution. Similarly, 37% reported that recommendations were up to the primary provider. Although most respondents include information about breast density in lay letters (73%) and radiology reports (89%), many feel that further patient education regarding breast density, supplemental screening, risk assessment, and screening guidelines should be performed by radiologists, and they are willing to provide additional patient education in these areas in practice. Conclusions: Survey respondents perceived current provider-patient discussions about the risks and benefits of breast cancer mammography screening and supplemental screening as inadequate and felt that standards should be developed. Respondents reported a willingness to take on patient education as part of their daily practice. These findings could inform future initiatives for radiologists to contribute to enhancing provider-patient education.
Language	English
Publishing date	2024-02-29
Publishing country	United States
Document type	Journal Article
ISSN	2631-6129
ISSN (online)	2631-6129
DOI	10.1093/jbi/wbz019
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Article ; Online: Unmet Spiritual Care Needs in Women Undergoing Core Needle Breast Biopsy.

Van Denburg, Alyssa N / Shelby, Rebecca A / Winger, Joseph G / Zhang, Lei / Soo, Adrianne E / Pearce, Michelle J / Soo, Mary Scott

Journal of breast imaging

2024 Volume 2, Issue 2, Page(s) 134–140

Abstract: Objective: Spiritual care is an important part of healthcare, especially when patients face a possible diagnosis of a life-threatening disease. This study examined the extent to which women undergoing core-needle breast biopsy desired spiritual support ... ...

Abstract	Objective: Spiritual care is an important part of healthcare, especially when patients face a possible diagnosis of a life-threatening disease. This study examined the extent to which women undergoing core-needle breast biopsy desired spiritual support and the degree to which women received the support they desired. Methods: Participants (N = 79) were women age 21 and older, who completed an ultrasound- or stereotactic-guided core-needle breast biopsy. Participants completed measures of spiritual needs and spiritual care. Medical and sociodemographic information were also collected. Independent sample t-tests and chi-square tests of examined differences based on demographic, medical, and biopsy-related variables. Results: Forty-eight participants (48/79; 60.8%) desired some degree of spiritual care during their breast biopsy, and 33 participants (33/78; 42.3%) wanted their healthcare team to address their spiritual needs. African American women were significantly more likely to desire some type of spiritual support compared to women who were not African American. Among the 79 participants, 16 (20.3%) reported a discrepancy between desired and received spiritual support. A significant association between discrepancies and biopsy results was found, χ 2(1) = 4.19, P = .04, such that 2 (7.4%) of 27 participants with results requiring surgery reported discrepancies, while 14 (26.9%) of 52 participants with a benign result reported discrepancies. Conclusion: Most women undergoing core-needle breast biopsy desired some degree of spiritual care. Although most reported that their spiritual needs were addressed, a subset of women received less care than desired. Our results suggest that healthcare providers should be aware of patients' desires for spiritual support, particularly among those with benign results.
Language	English
Publishing date	2024-02-29
Publishing country	United States
Document type	Journal Article
ISSN	2631-6129
ISSN (online)	2631-6129
DOI	10.1093/jbi/wbz089
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Dreams prior to biopsy for suspected breast cancer: A preliminary survey.

Burk, Larry / Wehner, DelMarie / Soo, Mary Scott

Explore (New York, N.Y.)

2020 Volume 16, Issue 6, Page(s) 407–409

Abstract: Warning dreams prior to the onset of symptoms have been reported in a previous survey of self-selected women with breast cancer. There is no available data on how many women with suspected breast cancer have such dreams, so anonymous surveys were offered ...

Abstract	Warning dreams prior to the onset of symptoms have been reported in a previous survey of self-selected women with breast cancer. There is no available data on how many women with suspected breast cancer have such dreams, so anonymous surveys were offered to women who came for biopsy at a university breast imaging center over a period of 3 months. 163 women completed the survey reporting that 64% usually remember their dreams, 41% have had dreams that came true, and 5% keep a dream diary. 5.5% reported dreaming the word "cancer," but only one woman was prompted to have a breast evaluation because of a dream. This pilot data will be used in planning a future study with pathological correlation.
MeSH term(s)	Biopsy, Large-Core Needle ; Breast Neoplasms/diagnosis ; Breast Neoplasms/psychology ; Dreams/psychology ; Female ; Humans ; Surveys and Questionnaires
Language	English
Publishing date	2020-03-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	2183945-1
ISSN	1878-7541 ; 1550-8307
ISSN (online)	1878-7541
ISSN	1550-8307
DOI	10.1016/j.explore.2020.03.002
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Article ; Online: Now or Later? Patient Satisfaction and Anxiety Among Women Undergoing Breast Biopsies Performed the Same Day as Recommended Versus a Later Day.

Grimm, Lars J / Shelby, Rebecca A / Destounis, Stamatia V / Knippa, Emily E / Langman, Eun L / Nedrud, Marybeth A / Musick, Alexis / Yoon, Sora / Johnson, Karen / Baker, Jay / Taylor-Cho, Michael / Soo, Mary Scott

Journal of the American College of Radiology : JACR

2024 Volume 21, Issue 3, Page(s) 415–424

Abstract: Purpose: The aim of this study was to determine differences in patient satisfaction and anxiety among women undergoing core-needle breast biopsies performed the same day as recommended versus a future date.: Methods: After institutional review board ... ...

Abstract	Purpose: The aim of this study was to determine differences in patient satisfaction and anxiety among women undergoing core-needle breast biopsies performed the same day as recommended versus a future date. Methods: After institutional review board exemption was granted, a survey was administered to patients at four sites on the day of imaging-guided core-needle breast biopsy. The survey was available from November 2020 through January 2022. Questions pertained to biopsy timing (same day versus later day), pre- and postbiopsy satisfaction with overall breast-care experience, biopsy wait-time satisfaction, pre- and postbiopsy anxiety, radiologist-patient communication, demographics, life stressors, breast cancer history, and risk factors. Comparisons were made between same-day and later-day biopsies by multivariable analysis. Results: Of 974 respondents (response rate 65.6%), almost half were scheduled for same-day biopsies (47.8% [466 of 974]). In multivariate analyses, same-day biopsies were associated with higher prebiopsy overall breast-care satisfaction (P < .001), higher wait-time satisfaction (P < .001), and higher prebiopsy (P = .001) and postbiopsy anxiety (P = .001). Better radiologist-patient communication was associated with lower prebiopsy anxiety (P < .001) and greater prebiopsy overall (P < .001) and wait-time (P < .001) satisfaction. Compared with White women, Black women reported lower postbiopsy anxiety (P < .001) but also lower prebiopsy satisfaction (P = .03) and wait-time satisfaction (P < .001). Conclusions: Same-day versus later-day biopsies resulted in better prebiopsy overall breast-care and wait-time patient satisfaction scores; however, no satisfaction differences were noted after biopsy. Clinically significant anxiety was associated with both same- and later-day biopsies but was higher for same-day biopsies. Higher anxiety levels correlated with lower overall satisfaction, suggesting that interventions to reduce anxiety and improve communication could improve patient experiences during same-day biopsies.
MeSH term(s)	Humans ; Female ; Patient Satisfaction ; Breast ; Anxiety/epidemiology ; Anxiety Disorders ; Biopsy/adverse effects
Language	English
Publishing date	2024-01-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2274861-1
ISSN	1558-349X ; 1546-1440
ISSN (online)	1558-349X
ISSN	1546-1440
DOI	10.1016/j.jacr.2023.07.028
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Article ; Online: Ductal Carcinoma In Situ Biology, Language, and Active Surveillance: A Survey of Breast Radiologists' Knowledge and Opinions.

Grimm, Lars J / Destounis, Stamatia V / Rahbar, Habib / Soo, Mary Scott / Poplack, Steven P

Journal of the American College of Radiology : JACR

2020 Volume 17, Issue 10, Page(s) 1252–1258

Abstract: Purpose: To understand how breast radiologists perceive ductal carcinoma in situ (DCIS).: Materials and methods: A 19-item survey was developed by the Society of Breast Imaging Patient Care and Delivery Committee and distributed to all Society of ... ...

Abstract	Purpose: To understand how breast radiologists perceive ductal carcinoma in situ (DCIS). Materials and methods: A 19-item survey was developed by the Society of Breast Imaging Patient Care and Delivery Committee and distributed to all Society of Breast Imaging members. The survey queried respondents' demographics, knowledge of DCIS biology, language used to discuss a new diagnosis of DCIS, and perspectives on active surveillance for DCIS. Five-point Likert scales (1 = strongly disagree, 3 = neutral, 5 = strongly agree) were used. Results: There were 536 responses for a response rate of 41%. There was agreement that DCIS is the primary driver of overdiagnosis in breast cancer screening (median 4), and respondents provided mean and median overdiagnosis estimates of 29.7% and 25% for low-grade DCIS as well as 4.2% and 0% for high-grade DCIS, respectively. Responses varied in how to describe DCIS but most often used the word "cancer" with a qualifier such as "early" (32%) or "pre-invasive" (25%). Respondents disagreed (median 2) with removing the word "carcinoma" from DCIS. Finally, there was agreement that current standard of care therapy for some forms of DCIS is overtreatment (median 4) and that active surveillance as an alternative management strategy should be studied (mean 4), but felt that ultrasound (median 4) and MRI (median 4) should be used to exclude women with occult invasive disease before active surveillance. Conclusions: Breast radiologists' opinions about DCIS biology, language, and active surveillance are not homogenous, but general trends exist that can be used to guide research, education, and advocacy efforts.
MeSH term(s)	Biology ; Breast Neoplasms/diagnostic imaging ; Carcinoma, Intraductal, Noninfiltrating/diagnostic imaging ; Female ; Humans ; Language ; Mammography ; Radiologists ; Surveys and Questionnaires ; Watchful Waiting
Language	English
Publishing date	2020-04-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2274861-1
ISSN	1558-349X ; 1546-1440
ISSN (online)	1558-349X
ISSN	1546-1440
DOI	10.1016/j.jacr.2020.03.004
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Article ; Online: Impact of Sodium Bicarbonate-Buffered Lidocaine on Patient Pain During Image-Guided Breast Biopsy.

Vasan, Alison / Baker, Jay A / Shelby, Rebecca A / Soo, Mary Scott C

Journal of the American College of Radiology : JACR

2017 Volume 14, Issue 9, Page(s) 1194–1201

Abstract: Purpose: This randomized, double-blind controlled study evaluated the effectiveness of sodium bicarbonate-buffered lidocaine on reducing pain during imaging-guided breast biopsies.: Materials and methods: This prospective, HIPAA-compliant study ... ...

Abstract	Purpose: This randomized, double-blind controlled study evaluated the effectiveness of sodium bicarbonate-buffered lidocaine on reducing pain during imaging-guided breast biopsies. Materials and methods: This prospective, HIPAA-compliant study randomly assigned 85 women undergoing ultrasound- or stereotactic-guided core-needle breast biopsies to receive intradermally and intraparenchymally either 1% lidocaine buffered with sodium bicarbonate (9:1 ratio) (bicarbonate study group) or 1% lidocaine alone (control group). Pain was evaluated using a 0-to-10 Likert pain scale during both intradermal and intraparenchymal anesthesia injections and during tissue sampling. Prebiopsy breast pain, anxiety, medical history, demographics, biopsy type, radiologist level of training, breast density, and lesion histology were recorded. Data were analyzed using analysis of variance and analysis of covariance. Results: Unadjusted mean pain scores were 1.47 and 2.07 (study and control groups, respectively; P = .15) during intradermal injections, and 1.84 and 2.98 (study and control groups, respectively; P = .03) during intraparenchymal injections. Tissue sampling mean pain scores were .81 and 1.71 (study and control groups, respectively; P = .07). Moderator analyses found (1) among patients with preprocedural pain, those in the bicarbonate group experienced less intradermal injection pain (0.85 ± 1.23) than patients in the control group (2.50 ± 2.09); (2) among patients with fatty or scattered fibroglandular tissue, those in the bicarbonate group (1.35 ± 1.95) experienced less intraparenchymal injection pain than the control group (3.52 ± 3.13); and (3) during ultrasound-guided biopsies, patients in the bicarbonate group experienced less tissue-sampling pain (0.23 ± 0.63) than the control group (1.79 ± 3.05). Conclusions: Overall, buffering lidocaine with sodium bicarbonate significantly reduced pain during intraparenchymal injections, and additional pain reduction was found in certain patient subgroups during intradermal injections, intraparenchymal injections, and tissue sampling.
Language	English
Publishing date	2017-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2274861-1
ISSN	1558-349X ; 1546-1440
ISSN (online)	1558-349X
ISSN	1546-1440
DOI	10.1016/j.jacr.2017.03.026
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