Digital breast tomosynthesis: sensitivity for cancer in younger symptomatic women.

OBJECTIVE: Full-field digital mammography (FFDM) has limited sensitivity for cancer in younger women with denser breasts. Digital breast tomosynthesis (DBT) can reduce the risk of cancer being obscured by overlying tissue. The primary study aim was to compare the sensitivity of FFDM, DBT and FFDM-plus-DBT in women under 60 years old with clinical suspicion of breast cancer. METHODS: This multicentre study recruited 446 patients from UK breast clinics. Participants underwent both standard FFDM and DBT. A blinded retrospective multireader study involving 12 readers and 300 mammograms (152 malignant and 148 benign cases) was conducted. RESULTS: Sensitivity for cancer was 86.6% with FFDM [95% CI (85.2-88.0%)], 89.1% with DBT [95% CI (88.2-90%)], and 91.7% with FFDM+DBT [95% CI (90.7-92.6%)]. In the densest breasts, the maximum sensitivity increment with FFDM +DBT over FFDM alone was 10.3%, varying by density measurement method. Overall specificity was 81.4% with FFDM [95% CI (80.5-82.3%)], 84.6% with DBT [95% CI (83.9-85.3%)], and 79.6% with FFDM +DBT [95% CI (79.0-80.2%)]. No differences were detected in accuracy of tumour measurement in unifocal cases. CONCLUSIONS: Where available, DBT merits first-line use in the under 60 age group in symptomatic breast clinics, particularly in women known to have very dense breasts. ADVANCES IN KNOWLEDGE: This study is one of very few to address the accuracy of DBT in symptomatic rather than screening patients. It quantifies the diagnostic gains of DBT in direct comparison with standard digital mammography, supporting informed decisions on appropriate use of DBT in this population.

Assessing the Adherence to Guidelines of Media Reporting of Suicide Using a Novel Instrument--the "Risk of Imitative Suicide Scale" (RISc).

Media guidelines for reporting of suicide are considered important in suicide prevention because of the risk of "imitative" suicide. There are currently no established tools for the quantification of quality of reporting. We sought to develop and validate a quality assessment instrument-the Risk of Imitative Suicide Scale (RISc). The RISc appears capable of discriminating reliably between adherent and nonadherent articles. Our data suggest that adherence to guidelines is inconsistent, and there are major differences between web-based and print media. The RISc could be used to evaluate effectiveness and consistency of media engagement with suicide prevention strategies.

A comparison of mood-dependent memory in bipolar disorder and normal controls.

Mood-dependent memory was investigated in a sample of 28 individuals, with a diagnosis of bipolar disorder I but not during acute episodes, and 30 non-clinical controls by using the word lists from Wechsler Memory Scale--Third Edition and abstract inkblot recognition. Positive or negative mood induction procedures were used prior to and after the stimuli were presented. After either the same or contrasting high or low mood inductions, participants attempted to recall the word list and performed an inkblot recognition task. Bipolar patients were significantly better at the inkblot recognition in the same mood state, showing mood-dependent memory. No differences were found in the verbal recall task. This study paves the way for further investigation into memory differences of this sort in mood disorders.