Pandemic Response to COVID-19: Lessons from Restructuring Breast Imaging at a Multi-site Academic Center in New York City.

PURPOSE OF REVIEW: The COVID-19 pandemic has been an unprecedented challenge for healthcare delivery, disrupting normal workflows and demanding re-allocation of resources. In the setting of breast imaging, this entailed an initial marked reduction of services during the acute phase of the pandemic followed by a gradual reopening with modified protocols to minimize potential virus exposure. RECENT FINDINGS: Protocols were devised for providing limited breast imaging services during the acute phase of the pandemic and for safely reopening during the post acute phase. Example cases of breast cancers diagnosed during the acute phase of the pandemic are provided to illustrate the modified workflow. SUMMARY: This manuscript reviews practical strategies for restructuring breast imaging workflow, onsite policies, and staffing at a multi-site academic center in New York City during the COVID-19 pandemic. By sharing our experience, we hope to provide others with a roadmap for managing breast imaging services during future unforseen crises.

Radiologic-Pathologic Correlation for Benign Results After MRI-Guided Breast Biopsy.

OBJECTIVE: The majority of MRI-guided breast biopsies yield benign pathology. The purpose of this article is to provide a comprehensive overview of benign pathologic entities commonly encountered at MRI-guided breast biopsy. CONCLUSION: Proper radiologic-pathologic correlation is an integral component of MRI-guided breast biopsy. Familiarity with the spectrum of MRI findings and key histopathologic features of common benign entities will enhance the radiologist's confidence in determining concordance and lead to improved patient management recommendations.

Breast cancer in male-to-female transsexuals: use of breast imaging for detection.

OBJECTIVE: The purposes of this article are to describe two cases of breast cancer in male-to-female transsexuals and to review eight cases previously reported in the literature. CONCLUSION: Breast cancer occurs in male-to-female transsexuals who receive high doses of exogenous estrogen and develop breast tissue histologically identical to that of a biologically female breast. This exposure to estrogen results in increased risk of breast cancer. The first patient described is a male-to-female transsexual with screening-detected ductal carcinoma in situ and a family history of breast cancer. The other patient is a male-to-female transsexual with invasive ductal carcinoma that was occult on diagnostic digital mammographic and ultrasound findings but visualized on digital breast tomosynthesis and breast MR images. The analysis of the eight previously reported cases showed that breast cancer in male-to-female transsexuals occurs at a younger age and is more frequently estrogen receptor negative than breast cancer in others born biologically male. Screening for breast cancer in male-to-female transsexuals should be undertaken for those with additional risk factors (e.g., family history, BRCA2 mutation, Klinefelter syndrome) and should be available to those who desire screening, preferably in a clinical trial.