M. El Khoury’s research while affiliated with Centre hospitalier de l'Université de Montréal (CHUM) and other places

Purpose: The purpose of this study was to identify practice trends and opinions concerning breast sonoelastography in two different health care systems, one in Europe (France) and the other in North America (Province of Québec/Canada). Materials and methods: We distributed an 11-item online survey among French and Canadian breast radiologists. The survey comprised of four sections: (i) personal practice characteristics, (ii) breast sonoelastography usage in daily practice and evaluation of its usefulness, (iii) limitations and roles of sonoelastogrpahy in their clinical practice, and (iv) types of elastographic technique and interpretation. Results: We found that sonoelastography of the breast appears unpopular among Canadian radiologists, and poorly credible among French radiologists, who perceive it as an unreliable technique. To date, its real impact in clinical practice remains uncertain. Conclusion: Continued learning and awareness of the indications, advantages and limitations of breast sonoelastography may motivate breast radiologists to adopt its use.

Background: Indications for breast magnetic resonance imaging (mri), a very sensitive but less-specific tool for breast investigation, remain controversial, and accessibility is limited. The purposes of our study were to determine the proportion of breast mri exams performed for various clinical indications, to assess the wait times for breast mri, and to create a list of evidence-based indications for breast mri. Methods: The indications for breast mri exams performed in September 2013 at our academic centre were audited. A multidisciplinary meeting held in May 2014 established a list of evidence-based indications for breast mri, after which, in September 2014 and 2015, breast mri exams were re-audited for clinical indications, and pending requests were calculated. Results: In September 2013, surveillance of women with a prior diagnosis of breast cancer represented 21% of breast mri exams (24 of 113), with preoperative staging representing 18% of exams (20 of 113) and high-risk screening representing 12% (13 of 113). Of pending mri requests, 230 were within the recommended delay period, and 457 exceeded the recommended delay. After elaboration of evidence-based guidelines, repeat audits in September 2014 and September 2015 showed that mri performed for women with a prior breast cancer diagnosis represented 23% (33 of 141) and 7% (10 of 143) of exams respectively, with preoperative staging having declined to 9% (13 of 141) and 11% (16 of 143) of exams, and high-risk screening having increased to 36% (51 of 141) and 46% (66 of 143) of exams. Overall, wait times were improved for all breast mri indications. Conclusions: Through multidisciplinary discussion, we actualized a list of breast mri indications, prioritized requests more adequately, and improved wait times.

Objective: Determine values of pathological analysis of the canister content during a vacuum-assisted breast biopsy (VABB). Methods: Approval was obtained from the ethical committee. Prospective radiological and pathological analyses of the canister content collected during 231 VABBs performed on 231 patients were carried out. χ(2) test was used to determine predictors on canister pathology. Results: The canister pathology was reported separately in 212 cases. It showed only blood in 78/212 (37%) cases and benign (including high-risk lesions) and malignant results in, respectively, 113/212 (53%) and 21/212 (10%) cases. Respective specimen analysis was benign, including high-risk lesions in 162/212 cases (76%) and malignant in 50/212 (24%) cases. Microcalcifications were documented on canister X-ray in 70/231 (30%) cases. There was significant association between the canister and the specimen pathology (p<0.0001). In none of the cases was microcalcifications seen exclusively in the canister content or pathological upgrading found in the canister content compared with the specimen. Conclusion: Small tissue fragments and microcalcifications may be lost in the canister during a VABB. Nevertheless, our results did not show any significant value for systematic analysis of the canister content. Advances in knowledge: There is no added diagnostic value to retrieval and analysis of tissue lost in the canister during a VABB.