In this Issue: January 2013

The controversy surrounding breast imaging is astounding. We have heard that we are over‐diagnosing – and thus over‐treating – breast cancer in a recent New England Journal of Medicine article. Then we are told that we are underdiagnosing breast cancer in patients with dense breast tissue and now must inform patients about the density of their breast tissue and that additional screening tests, such as US and MRI, may be useful. It would come as no surprise to me if breast imagers were as confused as our patients.

As breast imagers, we have to remember that early detection of breast cancer does indeed save lives. It has been shown that screening mammography decreases breast cancer deaths in up to 25‐30% of women. These results have been reaffirmed in multiple well designed, prospective, controlled studies. Nowadays, we must be cognizant of the issues surrounding breast imaging, as our patients often read about these issues in the Wall Street Journal or in the local newspaper. We have to arm ourselves with the scientific knowledge of proven research and technology. Breast imagers are direct patient advocates in the fight against breast cancer, and it takes special effort and fortitude to maintain that fight and keep our patients in the fold of our screening efforts. However, I believe it is well worth the time and energy that this requires.

I hope that the articles in this section of the JAOCR will help you in your practice. I was honored to be asked by Dr. William O’Brien to be the guest editor for the breast imaging section of the JAOCR. It is exciting to see this journal grow and even more exciting to be a part of this growth. You have to understand how much time Dr. O’Brien puts into each edition of the JAOCR. His expertise is astounding. I thank him and the JAOCR staff for all that they do.

Thanks also to the contributors to this edition of the JAOCR, to include Drs. Rocky Saenz, Luke and Geneva Ballard, Shannon Gaffney, and the breast imaging faculty at the University of Cincinnati. Without their time and energy, this edition would not have been possible. Special thanks to Dr. Lennard Nadalo for his help in editing my MRI breast article. He made it actually readable. Finally, thanks to my staff for helping me sift through almost 3,200 MRI breast cases and picking out the “great” ones (albeit slowly) for the article.

For those who know me, breast MRI is (and has been for awhile) a passion of mine. I enjoyed puttng pen to paper and looking over my cases for the past 5 years, and I am especially excited to share this information with you. I hope you find it useful. I hope everyone has a wonderful 2013. There are a lot of changes coming to healthcare. I can only hope that there are some beneficial changes amidst all of the controversy and craziness that seems to be part of the process. I hope that radiology — and more specifically breast imaging — will flourish, that research will continue to direct us, and that compassion will continue to drive us. Don’t lose sight of the reason you became a physician and specifically a radiologist. Ours is truly one of the great specialties.