Patient communication in radiology: current status of breaking bad news among radiologists and radiology trainees in Pakistan

Breaking bad news can be an intimidating task for any physician. The aim of this study was to record the practices of breaking bad news to the patients by Pakistani radiologists and trainees. The radiologists and trainees attending the 26[th] National Radiological Conference in October 2010 in Karachi, Pakistan, were surveyed. The response rate was 76%. The respondents included residents [51%], private practicing radiologists [28%], academic radiologists [13%], and other trainees [8%]. Most of the academic radiologists communicated with their patients. The daily frequency of breaking bad news by residents was noted, which was highest in the public teaching hospitals [71%]. For severe abnormalities such as malignancy, 50% residents, 55% of the academic radiologists and 74% of the private practicing radiologists were very malignancy, 50% residents, 55% of the academic radiologists and 74% of the private practicing radiologists were very uncomfortable in disclosure of results. Differences in frequency of communication with patients were noticed with both different training levels, and different settings of practice in a developing country

Utility of breast imaging in Mastalgia

Objective: To determine the use of breast imaging in patients with localised or diffuse pain in the breast, in the absence of palpable lump or nipple discharge

Design: Descriptive study

Setting: This study was conducted at Radiology Department of Civil Hospital and Dow University of Health Sciences Karachi from October 2007 to September 2008

Patients and Methods: Patients referred for radiological examination of breast[s] in which either mammography or ultrasound or both done were included. Inclusion criteria was pain in the breast present in women between the ages of 15-65 years. Exclusion criteria included palpable lump, and nipple discharge, patients with a history of breast cancer, or breast augmentation. Mammography was done in those who were above 35 years whereas the ultrasound was carried out in every patient with mastalgia. Main outcome measure was presence of the abnormal radiological findings. Findings were categorized in BIRADS terms. Statistical analysis was done for descriptive statistics. Mean +/- SD of age, numbers and percentage calculation for normal and abnormal findings were carried out

Results: Among the 175 subjects, pain was unilateral in 136 [77.5%] and bilateral in 39 [22.8%] patients. The mean age was 40 +/- 5 years [range 15-65 years]. Ninety-five [54.2%] women belonged to premenopausal or perimenopausal age group. The imaging findings were normal/negative in 114 [65.1%], benign in 43 [24.5%], probably benign in 12 [6.8%], suspicious in 04 [2.2%], and malignant in 02 [1.1%]

Conclusions: No abnormality was found in the painful area in majority of patients. A marked number of patients with benign or probably benign had pain in breast while probable or definite malignant disease was uncommon. Breast imaging in women who present with pain alone provides reassurance