Job satisfaction among radiology assistants: a multicentre cross-sectional study in Italy.

OBJECTIVES: Job satisfaction among physicians is an important occupational health issue since it is related to different factors such as work motivation or career decisions. The aim of this study was to investigate  job satisfaction among radiology assistants for the first time in Italy. METHODS: In 2012, a cross-sectional survey was conducted among a convenience sample of radiology assistants drawn from all Italian regions who submitted an electronic or paper-based self-administered questionnaire. The data collected were analysed using logistic regressions in order to assess the role of socio-demographic variables. RESULTS: Overall, 574 radiology assistants were interviewed. More than half of the subjects were males and  were younger than 40 years old. Around 76% of the sample was not satisfied  as regards salary. Moreover, the majority of the participants (66.1%) was not satisfied  with the professional refresher courses. Compared with males, females were more satisfied in terms of professional enrichment (OR=1.79, 95% CI: 1.23-2.62) but less satisfied with their relationships with superiors (OR=0.57, 95% CI: 0.38-0.85). CONCLUSIONS: Since radiology assistants and, in general, healthcare workers assist medical doctors, thus playing a  significant role  in safeguarding patients' health , it would be  desirable to give  due importance to the issue of job satisfaction,  from all points of view.

Does accelerated hypofractionated adjuvant whole-breast radiotherapy increase mammographic density or change mammographic features?

OBJECTIVE: To compare mammographic features before and after accelerated hypofractionated adjuvant whole-breast radiotherapy (AWB-RT) and to evaluate possible appearance of modifications. METHODS: A retrospective review of 177 females before and after an AWB-RT treatment (follow-up ranging from 5 to 9 years) was performed by four radiologists focused in breast imaging who independently evaluated diffuse mammographic density patterns and reported on possible onset of focal alterations; modifications in density and fibrosis with parenchymal distortion were deemed as indicators of AWB-RT treatment impact in breast imaging. RESULTS: Prevalent mammographic density (D) patterns in the 177 females evaluated were according to the American College of Radiology-Breast Imaging Reporting and Data System (ACR-BIRADS): D1, fibroadipose density (score percentage from 55.9% to 43.5%); and D2, scattered fibroglandular density (from 42.9% to 32.7%). No change in diffuse mammographic density and no significant difference in mammographic breast parenchymal structure were observed. "No change" was reported with score percentage from 87% to 79.6%. Appearance of fibrosis with parenchymal distortion was reported by all radiologists in only two cases (1.1%, p = 0.3); dystrophic calcification was identified with percentage score from 2.2% to 3.3% (small type) and from 9.6% to 12.9% (coarse type). CONCLUSION: No statistically significant changes in follow-up mammographies 5-9 years after AWB-RT were detected, justifying large-scale selection of AWB-RT treatment with no risk of altering radiological breast parameters of common use in tumour recurrence detection. ADVANCES IN KNOWLEDGE: The hypofractionated radiotherapy (AWB-RT treatment) is a new proven, safe and effective modality in post-operative patients with early breast cancer with excellent local control and survival. In our study, the absence of changes in mammographic density patterns and in breast imaging before and after AWB-RT treatment (up to 5-9 years after radiotherapy) justifies large-scale use of AWB-RT treatment without hindrance in tumour recurrence diagnosis.

Electron intraoperative treatment in patients with early-stage breast cancer: data update.

Intraoperative radiotherapy is a technique where a high, single-fraction radiation dose is delivered directly to the tumor bed during a surgical procedure, after the removal of a neoplastic mass, with minimal exposure of surroundings tissues, which are displaced and shielded during the procedure. Intraoperative radiotherapy has been used in the treatment of various malignancies, mostly in combination with external beam radiation therapy. The long-term results suggest a positive impact on local controls that appear to be associated with increased survival. Modern intraoperative radiotherapy can be performed either with electron beams or photons, and has been used recently in early-stage cancer as a boost or as an exclusive treatment, especially for breast tumors, with extremely promising results. The results of different clinical studies have demonstrated the feasibility of the technique and it is expected that its application will become more widespread in the immediate future. Intraoperative electron radiotherapy in the treatment of initial-stage breast cancer may be an excellent alternative to external beam radiation therapy in an appropriate selected group of patients. However, intensive long-term follow-up is required for a better evaluation of local control and possible side effects.