The average lifetime risk of breast cancer for a woman in the United States has been estimated at 12.3% (ie, 1 in 8 women). 1 For 2018, the American Cancer Society (ACS) estimates that 63,960 cases of female carcinoma in situ of the breast and 268,670 cases of invasive breast cancer (266,120 women and 2,550 men) will be diagnosed in the United States. 2 About 41,400 deaths are estimated for 2018. 3 The good news is that death rates have been falling on average NCCN

Purpose To evaluate whether semi-quantitative analysis of high temporal resolution dynamic contrast-enhanced MRI (DCE-MRI) acquired early in treatment can predict the response of locally advanced breast cancer (LABC) to neoadjuvant chemotherapy (NAC). Materials and Methods As part of an IRB-approved prospective study, 21 patients with LABC provided informed consent and underwent high temporal resolution 3 T DCE-MRI before and after 1 cycle of NAC. Using measurements performed by two radiologists, the following parameters were extracted for lesions at both examinations: lesion size (short and long axes, in both early and late phases of enhancement), radiologist’s subjective assessment of lesion enhancement, and percentages of voxels within the lesion demonstrating progressive, plateau, or washout kinetics. The latter data were calculated using two filters, one selecting for voxels enhancing ≥50% over baseline and one for voxels enhancing ≥100% over baseline. Pretreatment imaging parameters and parameter changes following cycle 1 of NAC were evaluated for their ability to discriminate patients with an eventual pathological complete response (pCR). Results All 21 patients completed NAC followed by surgery, with 9 patients achieving a pCR. No pretreatment imaging parameters were predictive of pCR. However, change after cycle 1 of NAC in percentage of voxels demonstrating washout kinetics with a 100% enhancement filter discriminated patients with an eventual pCR with an area under the receiver operating characteristic curve (AUC) of 0.77. Changes in other parameters, including lesion size, did not predict pCR. Conclusion Semi-quantitative analysis of high temporal resolution DCE-MRI in patients with LABC can discriminate patients with an eventual pCR after one cycle of NAC.

Objective This study assessed mentorship interest within the breast radiologist community to guide development of a mentorship program through the Society of Breast Imaging (SBI). Methods A 19-question survey developed by the SBI mentorship committee was distributed electronically to its members March 16, 2021, to May 7, 2021, to gauge interest in forming a society-sponsored mentorship program. Responses were analyzed, with subgroups compared using chi-square analysis. Results There was an 18% response rate (598/3277), and 65% (381/588) professed interest in an SBI-sponsored mentorship. Respondents were evenly distributed between academic (241/586, 41%) and private practice (242/586, 41%). Most were breast imaging fellowship-trained (355/593, 60%) and identified as female (420/596, 70%). For practice years, 50% (293/586) were late career (11+ years) with the remainder early-mid career (201/586, 34%) or trainees (92/586, 16%). For mentorship content areas, work/life balance was the most popular choice (275/395, 70%) followed by leadership (234/395, 59%). Most respondents were not currently mentors (279/377, 74%) or mentees (284/337, 84%). Those interested in a mentorship relationship were statistically younger (<45 years old, 234/381, 61% vs 31/207, 15%, P < 0.00001), female (289/381, 76% vs 123/207, 59%, P = 0.00003), academics (189/381, 50% vs 48/207, 23%, P < 0.00001), identified as a racial/ethnic minority (138/381, 64% vs 121/297, 15%, P < 0.00001), and fellowship-trained (262/381, 69% vs 88/207, 43%, P < 0.00001). Conclusion There is demand, especially among the society’s young and minority members, for an SBI-sponsored mentorship program. Work/life balance and leadership were the most popular choices for guidance.

Purpose Signal voids caused by metallic needles pose visualization and monitoring challenges in many MRI applications. In this work, we explore a solution to this problem in the form of an active shim insert that fits inside a needle and corrects the field disturbance (ΔB0) caused by the needle outside of it. Methods The ΔB0 induced by a 4 mm outside‐diameter titanium needle at 3T is modeled and a two‐coil orthogonal shim set is designed and fabricated to shim the ΔB0. Signal recovery around the needle is assessed in multiple orientations in a water phantom with four different pulse sequences. Phase stability around the needle is assessed in an ex‐vivo porcine tissue dynamic gradient echo experiment with and without shimming. Additionally, heating of the shim insert is assessed under 8 min of continuous operation with 1A current and concurrent imaging. Results An average recovery of ~63% of lost signal around the needle across orientations is shown with active shimming with a maximum current of 1.172 A. Signal recovery and correction of the underlying ΔB0 is shown to be independent of imaging sequence. Needle‐induced phase gradients outside the perceptible signal void are also minimized with active shimming. Temperature rise of up to 0.9° Celsius is noted over 8 min of continuous 1A active shimming operation. Conclusion A sequence independent method for minimization of metallic needle induced signal loss using an active shim insert is presented. The method has potential benefits in a range of qualitative and quantitative interventional MRI applications.