Acrometastasis in Breast Carcinoma.

Background: Metastasis to the bone in breast cancer patients is common, but metastasis specifically to the appendicular skeleton is rare. A limited number of cases in the literature describe metastatic breast cancer to the distal limbs, also known as acrometastasis. Acrometastasis in a patient with breast cancer should prompt evaluation for diffuse metastatic disease. Case Report: We describe the case of a patient with recurrent triple-negative metastatic breast cancer who presented with thumb pain and swelling. Radiograph of the hand demonstrated focal soft tissue swelling over the first distal phalanx with erosive changes to the bone. Palliative radiation to the thumb resulted in symptom improvement. However, the patient succumbed to widespread metastatic disease. At autopsy, the thumb lesion was confirmed as metastatic breast adenocarcinoma. Conclusion: Metastatic breast carcinoma to the distal appendicular skeleton, specifically to the first digit, is a rare presentation of bony metastasis and can be an indication of late, widespread disease.

A Problem of Gender Representation: Adapting the Bechdel Test to Evaluate the Social Media Presence of Radiology Residency Programs.

RATIONALE AND OBJECTIVES: Social media serves as recruitment tools for residency programs, allowing programs to "brand" themselves in an era of virtual interviews. For female applicants, viewing their gender represented on Instagram may influence their pursuit of a program. Our study's goal is to quantify how female-presenting professionals are represented on radiology residency (RR) Instagram pages, as these are increasingly important platforms for resident recruitment. MATERIALS AND METHODS: The Bechdel test is a well-known measure of the representation of women in fiction that requires at least 2 women speak to each other about a topic other than a man. We modified this test to evaluate the portrayal of female-presenting professionals on public Instagram galleries of RR programs. For a photo to pass our test, female-presenting persons are shown physically together, without male-presenting professionals, and in a professional setting. To compare gender depiction, a Male Bechdel Test was also used. RR Instagram pages were identified using the Fellowship and Residency Electronic Interactive Database Access (n = 87) and examined with an adapted framework approach to count female and male-presenting individuals in 1044 images. Results were assessed using paired t-tests and a chi-square with McNemar's test. RESULTS: Approximately 50% of the RR Instagrams passed the Male Bechdel Test while only 21.3% passed the Female Bechdel Test, a significant difference in gender representation (χ2(1) = 13.255, P = 0.022). Paired sample t-tests revealed that RR Instagram pages are significantly more likely to feature male-presenting professionals in a professional setting (P < 0.0001), feature them with other male-presenting professionals (P = 0.001), and feature them without female-presenting professionals (P = 0.003). CONCLUSION: Our results suggest female-presenting radiologists are under-represented on the Instagram profiles of RR programs. While this reflects the dearth of females in this field, programs may improve gender inclusion by more prominently displaying females on social media. This may assist in recruiting minority applicants.