Page 7 - ABUS-Casestudy

Dr. Jose Carmelo Dr. Maria Teresa Fernandez At a glance

Albillos Merino, MD Taranilla, MD, PhD Practice setting – Multidisciplinary breast
department in a University Public Academic
Head of Radiology Department Consultant Radiologist of the Breast Care Unit Hospital
Hospital Universitario 12 de Octubre Hospital Universitario 12 de Octubre Department staffing – 9 radiologists,
Madrid, Spain Madrid, Spain 11 technicians, 2 nurses and 1 patient
coordinator
Modalities – FFDM, DBT, HHUS, ABUS,
US-MRI Fusion and MRI
Patient volume – 20.000 patients/year:
60% diagnostic; 40% screening
Coverage / reimbursement – Government-
funded national healthcare program that
includes supplemental screening if needed;
Supplemental imaging is free, following
radiologist criteria
Country guideline – Government screening
The site program (FFDM for women 50-69 years old
The Breast Care Unit of the Hospital Universitario 12 de Octubre is designed to ensure accurate and every 2 years), EUSOBI guidelines
fast diagnoses, individualized treatments and risk based follow-up of patients. The multidisciplinary Risk stratification – Patients referred to
team includes gynecological and plastic surgeons, radiologist, anesthesiologist, oncologist with oncology department if any familial history/
genetic counseling, nuclear medicine and rehabilitation physicians. All of them focus on breast suspicious; oncology performs risk assessment
care patients. The Hospital Universitario 12 de Octubre performs per year 20,000 diagnostic and sends patient to radiology for imaging.
exams, 6,000 screening exams and 3,500 opportunistics exams. CanRisk, BOADICEA and Tyrer-Cuzick model

Care pathway for patients with dense breasts

In Spain, the limitations of mammography in women with dense breasts are well known. Hospital “ A major benefit of ABUS is being
12 de Octubre takes care of patient populations of 500,000 including the screening program. Breast reproducible and standardized,
MRI is performed only in high risk patients (>20%) combined with annual mammography as a screening which is the main drawback of
tool and in selected cases with extremely dense breasts. ABUS is implemented during the annual HHUS, also the coronal plane helps
follow-up of patients with intermediate risk (15-20%) and dense breasts (BI-RADS C and D) and also physicians in cases with multiple
in opportunistic screening as a supplemental technique to increase sensitivity of mammography.
nodules and is easy to compare
with coronal planes on MRI.”

Screening Risk assessment performed in oncology;
decision tree referred to radiology for imaging “ We have a very full schedule on
our daily routine, so ABUS provides
a tool to help achieve a more
efficient workflow, in order to save
FFDM for DBT for women radiologists time to focus on really
screening women with dense complex cases.”
[50-69] every breasts
2 years

Diagnostic ABUS
Hospital 12 de Octubre applies diagnostic
ABUS in women who are over 35 years old
with dense breasts and palpable lump
(followed by HHUS if needed) and also
in the follow-up of patients with known
benign nodules BI-RADS 3. In cases with
Breast MRI for high-risk ABUS for intermediate risk HHUS BI-RADS 4 on ABUS, a HHUS is performed
patients* followed by HHUS if any afterwards (core needle biopsy) and a
suspicious findings
* MR not widely available in Spain – Breast MRI to stage the disease.
replace with ABUS if MRI not available