Developing an Education Pathway for Breast Cancer Patients Receiving Rapid Diagnostic Testing: Investigating Informational and Supportive Care Needs.

Several studies have examined the informational needs of patients undergoing the breast diagnostic process where needs are highest during testing and prior to receiving a diagnosis. To aid in the development of an education pathway, we identified patient information needs. A multi-method approach to identify areas of need and to understand when and how information should be provided to patients was undertaken. The methods included an environmental scan of consumer health information, ethnographic observation of the patient clinical experience, key informant interviews, and a needs assessment survey. The data collected from the environmental scan, ethnography, and interviews were used to develop the items in the survey. The survey was developed around four domains: (1) Medical Procedures and Tests, (2) Understanding the Rapid Diagnostic Process, (3) Breast Cancer and Other Breast Conditions, and (4) Support and Coping. A total of 101 patients completed the survey. Mean importance scores were significantly different between domains of information need (p < .0001) and significantly higher for the 'Medical Procedures and Tests' domain compared with all others. Multivariate analysis suggested that participants with higher levels of education (p = .02) and a preference to speak English at home (p = .009) tended to rate the importance of 'Support and Coping' information lower than other participants. Information about medical procedures and tests are most important for the patients undergoing rapid diagnostic testing in our sample. Education materials that are tailored to patient needs should be provided to patients during this stage of the cancer journey to help meet informational needs.

Clinical prevalence and outcome of cardiovascular events in the first 100 days postallogeneic hematopoietic stem cell transplant.

INTRODUCTION: Recent advances in allogeneic hematopoietic stem cell transplant (HSCT) have allowed us to offer HSCT to older, advanced disease patients with more co-morbidities. Cardiovascular toxicity post-transplant is a major concern due to the increased risk of mortality. Few studies have examined the prevalence of CV events including CAD (MI, angina, PCI, CABG, CHF, arrhythmias), HTN, stroke/TIA, and death in the first 100 days post-transplant. PATIENTS: We assessed the impact of pretransplant MUGA results in predicting postallogeneic HSCT CV events and overall survival in the first 100 days, and whether or not transient anthracycline-induced cardiomyopathy or cumulative anthracycline dose affected overall survival. This retrospective, cohort study included 665 patients with a median age of 52 years who underwent HSCT from 2009 to 2015. RESULTS: The most frequent CV event in the first 100 days post-HSCT was arrhythmia seen in 2.9% of patients followed up by CHF (12.3%), MI (9%), and angina (8%). Two patients had PCI, and both survived the first 100 days. Cardiovascular risk factors predict for a poor MUGA scan but not survival. Higher dose anthracycline pretransplant predicted for a poor outcome. CONCLUSION: A history of CV disease, MI, or CAD was the most important predictive of CV events, P-value = .00002. 88.6% survived the first 100 days. Patients with an EF < 50% had a significant likelihood of having a CV event compared to patients with an EF > 60% (OR = 5.3, 95% CI [1.6-18.1], P = .0219). Cumulative anthracycline dose did not have a significant impact on overall survival.

Error rates in breast imaging reports: comparison of automatic speech recognition and dictation transcription.

OBJECTIVE: The purpose of this study was to compare the error rates in breast imaging reports generated with automated speech recognition (ASR) technology as opposed to conventional dictation transcription. MATERIALS AND METHODS: Breast imaging reports reviewed from January 2009 to April 2010 during multidisciplinary tumor board meetings at two hospitals were scrutinized for minor and major errors. RESULTS: Of 615 reports obtained, 308 were generated with ASR and 307 with conventional dictation transcription. At least one major error was found in 23% of ASR reports, as opposed to 4% of conventional dictation transcription reports (p < 0.01). Major errors were more common in breast MRI reports (35% of ASR and 7% of conventional reports), the lowest error rates occurring in reports of interventional procedures (13% of ASR and 4% of conventional reports) and mammography reports (15% of ASR and no conventional reports) (p < 0.01). The error rates did not differ substantially between reports generated by staff radiologists and trainees or between reports generated by speakers who spoke English as their first language and those whose native language was not English. After adjustment for academic rank, native language, and imaging modality, reports generated with ASR were 8 times as likely as conventional dictation transcription reports to contain major errors (p < 0.01). CONCLUSION: Reports generated with ASR are associated with higher error rates than reports generated with conventional dictation transcription. The imaging modality used is a predictor of the occurrence of reporting errors. Conversely, native language and academic rank of the speaker do not have a significant influence on error rate.

Imaging approaches and findings in the reconstructed breast: a pictorial essay.

Advances in breast imaging over the last 15 years have improved early breast cancer detection and management. After treatment for breast cancer, many women choose to have reconstructive surgery. In addition, with the availability of widespread genetic screening for breast cancer, an increasing number of women are choosing prophylactic mastectomies and subsequent breast reconstruction. The purpose of this pictorial essay is to present the spectrum of imaging findings in the reconstructed breast.