ECR 2019 TOPIC PACKAGE

Breast cancer

  • 12 LECTURES
  • 280 MINUTES
  • 11 SPEAKERS
  • ESR MEMBERS €9
  • NON-MEMBERS €19

Learning Objectives:

Overdiagnosis in breast cancer screening: the epidemiologist's

  1. To learn about estimation of overdiagnosis with minimal assumptions.
  2. To understand the potential biases in estimating favourable and unfavourable effects of screening.
  3. To appreciate the connection between the epidemiological definition of overdiagnosis and its clinical implications.
  4. To understand the arguments for and against organised screening programmes.
 

What can the radiologist do to limit overdiagnosis?

  1. To estimate test sensitivity in relation to programme sensitivity in screening.
  2. To learn what the optimal test for population based screening is: FFDM or tomosynthesis in relation to overdiagnosis.
  3. To understand that there are lesions not to be recalled from screening.
  4. To learn the place of the ultrasound of the axilla: in BI-RADS 4, 5 or never?
 

Are there breast cancers we do not have to treat?

  1. To review side effects of current treatments.
  2. To be able to discuss what lesions we could consider reducing treatment burden.
  3. To learn about radiological options to the current surgical treatment paradigm.
  4. To learn about 'active monitoring' as a new treatment option.
 

Lesions with an elevated risk for breast cancer

  1. To learn about different types of high-risk lesions.
  2. To become familiar with the risk of developing cancer.
  3. To appreciate the different imaging modalities for diagnosis.
 

Value of breast MRI. Rate of underestimation and impact on

  1. To learn about the evidence on MRI for evaluating high-risk lesions.
  2. To become familiar with various imaging appearances of high-risk lesions.
  3. To appreciate the added value for diagnosis and treatment decision.
 

Can surgery be avoided?

  1. To learn about the different image guided minimally-invasive modalities to excise high-risk lesions.
  2. To become familiar with the risk of avoiding surgery.
  3. To appreciate the standard protocols in different countries.
 

New radiologic-pathologic knowledge on DCIS

  1. To learn about different types of DCIS.
  2. To become familiar with the risk of developing cancer.
  3. To appreciate radiologic-pathologic correlations.
 

Imaging DCIS

  1. To become familiar with the imaging appearances of DCIS on mammography, ultrasound and MRI.
  2. To understand the evidence on MRI for evaluating DCIS.
  3. To appreciate the overlap of imaging features of DCIS and benign disease.
 

Diagnosing DCIS with biopsy

  1. To learn about the indications for biopsy when DCIS is suspected based on imaging.
  2. To become familiar with the advantages and disadvantages of different biopsy techniques.
  3. To appreciate the risk of overdiagnosis and overtreatment with DCIS.
 

High-intensity focused ultrasound (HIFU) therapy

  1. To learn about the basics of HIFU therapy.
  2. To become familiar with the different types of imaging guidance.
  3. To appreciate its role in treating benign and malignant lesions.
 

Radiofrequency ablation therapy

  1. To learn about how radiofrequency works.
  2. To become familiar with its use in clinical practice.
  3. To appreciate the advantages and disadvantages.
 

Cryotherapy

  1. To learn about the cryotherapy technique.
  2. To become familiar with its use in clinical practice.
  3. To appreciate its role in treating benign and malignant lesions.

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