REPORT BACI<

Report on the
Breast Ultrasound

and Mammography
Workshop

held in Pretoria, 23-26
September 1999

Garth Kruger
MBChB, MMed(Pret)

Chairman, Mammography Subgroup, RSSA

T he Radiological Society organised
a BreastUltrasound and Mammography
Workshop as part of the 1999 South
African Radiology Congress at the
CSIR Conference Centre from 23 to
26 September 1999. The congress was
organised with the co-operation of the
faculty members of The International
Breast Ultrasound School (IBUS).

Speakers attending the Congress
were Dr Edward Azavedo and Dr
Gunilla Svane from the Karolinska
Hospital in Stockholm and Dr
Roberta Chersevani from Gorizia in
Italy.

A wide spectrum of topics was dis-
cussed starting with the basics of
mammographic criteria and ending up
with future developments in senology.

The panel of speakers continued
to reiterate the importance of quality
assurance and quality control in
senology as well as the accreditation

of radiologists involved in breast
imaging. These are two topics which
will have to be addressed by the Ra-
diological Society in the very near
future.

We cannot continue breast
imaging in South Africa without some
form of accreditation of the people
doing the imaging and some sort of
control over whether there is any
quality assurance in institutions do-
ing breast imaging.

A further fact that emerged from
the Congress, as well as from the dis-
cussions, is the continuing question of
MR imaging of the breasts. There is a
very long learning curve in MR
imaging of the breasts and it seems
that this examination should only be
performed in institutions where they
have a high turnover of cases and
where they have experience. It is an
open question whether this examina-
tion should be performed in South
Africa at all.

The syllabus that was given out
during the Congress contains a handy
number of lectures including some
interesting lectures about fine needle

28 SA JOURNAL OF RADIOLOGY. January 2000

aspiration and the pathological cor-
relation between pathology slides and
mammography. More and more em-
phasis is today being placed on the
importance of ultrasound. High-end
equipment should be used with 7.5
or 10 MHz linear transducers.
Speaker after speaker confirmed the
importance of the technical specifi-
cations of the machine.

The importance of fine needle as-
piration versus core biopsies and
minimally invasive breast biopsy
(MIBB) was again discussed at the
Congress. The absolute importance
of the availability of a dedicated
breast cytologist was emphasized
again and again. In fact, some of the
speakers felt that if a dedicated breast
cytology service was not available,
that the radiologist should rather be
doing core biopsies. The other advan-
tage of core biopsies is that oestro-
gen receptor status can be done on a
core specimen. This enables a defi-
nite pre-operative diagnosis to be
made and different treatment
modalities discussed with the patient.
The ideal situation is where all breast
surgery candidates have a pre-opera-
tive diagnosis. As far as possible the
use of frozen sections in theatre
should be limited by a proper pre-
operative work-up.

The workshop sessions consisted
of hands-on sessions with ultrasound
as well as needle biopsies of the
breasts. There were also interactive
workshops demonstrating a wide va-
riety of pathology in both mammog-
raphy and pathological slides with
correlation between the two.

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