7 boards of hospitals to institute as there is no national policy on it yet. The Radiology department (mammography unit) of the University of Maiduguri Teaching Hospital installed a GE Senographe DMR (with stereotaxic attachment) and GE LOGIQ ultrasonography machine (with linear probe 12MHz), in 2007. The hospital constituted a multi-disciplinary team (MDT), consisting of the relevant professionals who all have breast care subspecialty training and are licensed by the relevant local professional regulatory bodies which formulate policies and guidelines for the relevant interventions. They develop the hospital breast care protocol to ensure that the best patient outcome is achieved. This retrospective study is aimed at assessing and documenting the contribution of the breast imaging unit to early detection and best available intervention as a means of evidence based practice. Methods: The data of all the females imaged at our facility from 2010 to 2013 were reviewed and analyzed. All patients from age 35 had mammograms, while symptomatic patients below the age of 35 years start with sono-mammograms. All masses were biopsied. Results: A total of 913 females were seen during the study period: Screening 612 (67%), diagnostic 301(33%). Total malignancy detected were 54(6.3%): Screening 8(1.3%), diagnostic 46(15.2%). Nine patients below 35 years had cancer Correlating histological and multi-imaging results has yielded more accurate diagnosis. This study showed a high rate of incidence of malignancy, late presentation and a number of women under 35 years having cancer suggesting that breast care need urgent focus in this locality. 2.2. Breast Diagnosis and Pathology. The Consultant Mammographer’s view Presenter: Dawn McDonald, Imperial College Trust, London Author: Dawn McDonald Introduction: The journey to become a Consultant Mammographer takes many years to complete, and from qualifying as a basic grade radiographer it can take as long as 10 years, longer for some, to obtain the necessary skills and qualification. The clinical skills, known as core modules, include breast examination and client communication, film reading, breast ultrasound, and breast interventional. They are all academically very challenging to obtain, each module taking approximately one year to complete. The radiographer will quite often be known as an Advanced Practitioner during part of this phase. Completing a Master’s Degree and undertaking Research should result in the title of a Consultant Radiographer. A very large volume of work is required to be covered, and this can lead to moments of 'high's' as well as 'low's'. Audit and Research are also subjects that a Consultant Radiographer should be involved in, and are tools that can be used to improve the service. This is by identifying and managing any emerging trends. The result of this can help the Consultant to instigate a change in practice, and help improve the patient pathway. Although support may be given from some clinical staff, it is not always given by all. However, with the demand for breast services increasing, the role of the Consulant Radiographer is showing to be more useful in that they can help reduce the clinical workload; working within a clinical setting, and having complete autonomy over the running of a breast clinic helps a busy breast unit on a daily, and weekly basis. Methods: A Power point presentation showing interesting, and up-todate, case studies to illustrate the role of the Consultant Mammographer, and how this role can be beneficial within a clinical setting. Results: Many attributes are required to be successful to gain this role, including determination, motivation, time, and support- and this is not always given. And- despite the best of intentions-, things will sometimes go wrong in a clinical setting- as illustrated in the final case study illustrating a Wire Localization. The number of Consultant Radiographers within the UK is growing, (currently approx. ) but there is still room for many more. 2.3. A proposed training program to support an extended scope of practice for South African mammographers Presenter: Amanda Louw, University of Johannesburg, South Africa Author: Amanda Louw Introduction: Breast imaging is vital in detecting breast cancer but a shortage of radiologists in the public sector in South Africa contributes to a sub-optimal breast imaging service. Whereas numerous tactics can address the radiologist shortage, this research focuses on developing the professional skills of mammographers to enable them to carry part of the workload of radiologists. Mammographers, already breast imaging specialists in terms of the production of x-ray images, are the logical choice for such development due to their existing base of knowledge in the field. The research question underpinning this study is “What training is needed to extend the mammographer scope of practice in South Africa in terms of breast ultrasound and breast image interpretation?” The aim of the study is to develop, clinically implement, test and refine a training program to equip South African mammographers with breast ultrasound and -image interpretation skills. Currently, South African mammographers are limited by their professional scope of practice to perform only conventional breast x-ray imaging. The developed training program will be underpinned by research evidence and subjected to cycles of refinement in order to present to the Health Professions Council of South Africa (HPCSA) as the first step on the way to extend the professional scope of practice of mammographers. International guidance is taken from the Breast Health Global Initiative who identifies best practices with limited resources in breast health care, as well as the United Kingdom, who played a leading role in mammographer role extension over the past 30 years. Methods: The study is innovative, exploratory and follows a development research design. Qualitative methods address existing training, formative expert- and post-training feedback. Quantitative data indicates pre- and post-training knowledge. Results: Anticipated results will be discussed by referring to literature and global trends. In South Africa, breast imaging needs exist mainly in the public sector. However, implementation of the proposed National Health Insurance could further increase the demand in the public sector and affect the availability of radiologists in the private sector. A proactive response to this possible increased pressure would be a multi-skilled mammographer who can perform some functions of a radiologist. 2.4. An Appraisal of Male Breast Imaging- our experience Presenter: Mosunmola Oyinade Okedayo, Radiology Department, University of Maiduguri Teaching Hospital, Maiduguri, Borno state, Nigeria Authors: Mosunmola Oyinade Okedayo, Z. Mustapha, A. Ahmed, I. Garba Introduction: Males are affected by both benign and malignant breast lesions as females, although at a lower frequency. Unlike in the developed countries, Nigeria, like many other developing countries, has no national policy to tackle the scourge of breast cancer. Inadequate public awareness about the role of early detection as a means of reducing morbidity and mortality has not helped in alleviating its increasing burden on the populace. Studies have documented that the incidences of breast cancer is on the increase in the sub- Saharan Africa and about 1% of it affects the males. Gynecomastia and cancer are the commonest lesions affecting the male breast, the former being the most frequent. The patients usually present with history of pain, tenderness and swelling of the breast either bilaterally or unilaterally. A study on breast malignancies from 1989-2003 in our hospital, showed incidence of male breast cancer to be 3.7% (male to female ratio 1:26), while another study in the same hospital from 2001 to 2005 reported 4.7% of breast cancers were in males (male to female ratio 1:20). They all presented at the hospital at an advanced stage and all occurred pre mammography unit installation. This hospital established a mammography unit with GE Senographe DMR equipment with stereotaxic attachment and GE LOGIQ sono equipment (with linear probe 12MHz) in 2007. A multidisciplinary breast care team (MDT) was constituted to create awareness and formulate policies and breast care protocol for interventions. This retrospective study is aimed at determining and illustrating the pattern of findings among the male patients who attended our mammography facility from installation to date. Methods: Data of all the ten males who were imaged at the mammography unit of our hospital from September 2007 to December 2013 were retrospectively reviewed and analyzed. Nine had mammograms; all had sonomammograms, while six of them had a core biopsy. Results: The ten males (mean age 31.1 ± 13. Age range 14-58years), were all diagnosed with benign findings: True gynecomastia 7(70%), acute mastitis1 (10%), pseudo gynecomastia 2 (20%). No case of malignancy was seen Gynecomastia is the most common finding amongst the males in this study. Our protocol of multi-imaging and correlating with histological results has helped in more accurate diagnosis.
ISRRT | Book Of Abstracts
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