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.

Reprint of: Breast tissue markers: Why? What's out there? How do I choose?

Tissue marker placement after image-guided breast biopsy has become a routine component of clinical practice. Marker placement distinguishes multiple biopsied lesions within the same breast, prevents re-biopsy of benign lesions, enables multi-modality correlation, guides pre-operative localization and helps confirm surgical target removal. Numerous breast tissue markers are currently available, with varied shapes, composition, and associated bio-absorbable components. This review serves to familiarize the breast interventionalist with the tissue markers most widely available in the United States today and to provide guidance regarding selection of appropriate markers for various clinical settings.

Breast tissue markers: Why? What's out there? How do I choose?

Tissue marker placement after image-guided breast biopsy has become a routine component of clinical practice. Marker placement distinguishes multiple biopsied lesions within the same breast, prevents re-biopsy of benign lesions, enables multi-modality correlation, guides pre-operative localization and helps confirm surgical target removal. Numerous breast tissue markers are currently available, with varied shapes, composition, and associated bio-absorbable components. This review serves to familiarize the breast interventionalist with the tissue markers most widely available in the United States today and to provide guidance regarding selection of appropriate markers for various clinical settings.

Breast Imaging of Transgender Individuals: A Review.

PURPOSE: This review will inform radiologists about the evidence base regarding radiographic imaging for transgender individuals and considerations for providing culturally sensitive care for this population. FINDINGS: Transgender individuals are increasingly referred for both screening and diagnostic breast imaging. It is important that the clinic environment is welcoming, the medical staff utilize accepted terminology and patients are able to designate their gender and personal history to ensure appropriate care. Hormone and surgical treatments used for transition by many transgender women and men may change the approach to imaging. SUMMARY: Although not yet evidence-based, screening mammography is currently suggested for transgender women with risk factors, including those receiving hormone treatment over 5 years. The risk for breast cancer in transgender individuals is still being defined.

Power-pulse spray thrombectomy for treatment of Paget-Schroetter syndrome.

OBJECTIVE: This initial single-center study describes three cases of axillary-subclavian vein thrombosis (Paget-Schroetter syndrome) treated with a rapid, novel thrombectomy technique, termed "power-pulse spray thrombectomy," in which a thrombolytic agent is directly infused into the clot via a catheter, followed by intravascular mechanical clot fracture and removal. CONCLUSION: All patients in this series were treated in a single session. Complete clot removal was successfully achieved without the development of any complications. This is the first description of the application of this technique in the treatment of Paget-Schroetter syndrome to our knowledge.