REPORT BACI<

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Report on the
Second

International
Breast Imaging

Update - IBUS -
Freiburg, Germany,

15-17 October 1999

Freiburg is a city of 200 000 inhab-
itants of which 10% are students. It is
located in the south west of Ger-
many in the area where Germany,
France and Switzerland meet. The
Congress was held in the
Konzerthaus.

It was organised by the Interna-
tional Breast Ultrasound School in
conjunction with the August Ludwig
University of Freiburg. The congress
covered the whole range of topics in
mammography.

It was also very interesting to see
that a full series of hands-on work-
shops ranging from ultrasound to
minimally invasive breast biopsies to
pathology and breast intervention
were held for all the delegates.

A pathologist presented one of the
most interesting sessions that I at-
tended. There was an introductory
course into breast cyto-pathology,

which was very interesting. A practi-
cal demonstration with a wide range
of slides demonstrating the problems
of cytology was covered in this ses-
sion of nearly two-and-a-halfhours. I
think that all breast imagers should
make an effort to get some basic ex-
posure in pathology especially now
that we are doing such a lot of breast
intervention. It gives you insight into
the practical problems of breast cy-
tology and why the reports look the
way they do.

A large technical display was on
at the same time. Interesting devel-
opments as far as apparatus is con-
cerned is from Mamrnotome (which
is marketed by Johnson & Johnson in
South Africa). The Mamrnotome
machine is well known to breast
imagers. It is a vacuum biopsy device.
The problem with this equipment in
the past was that you had to have a

30 SA JOURNAL OF RADIOLOGY- January 2000

special table and apparatus. They have
now brought out a hand-held breast
vacuum biopsy device. This has great
potential in use under ultrasound
guidance. The apparatus was practi-
cally demonstrated to us. It has all the
advantages of the larger apparatus and
prone tables with very few disadvan-
tages. The apparatus is easy to use and
practical with distinct advantages for
the patient. On a practical video
linked to the local hospital, excision
of a fibro-adenoma under local anaes-
thetic with a hand-held Mamrnotome
machine, was performed within 15
minutes. The complete fibro-ad-
enoma was removed.

As far as ultrasound is concerned,
a very interesting lecture was given
about a standardised version of guide-
lines for use of ultrasound. Worldwide
it seems that we all have the same
problems as far as the use of ultra-
sound is concerned. lEUS has now laid
down criteria and invited comment
on a set of standards whereby the user
of ultrasound equipment will have to
undergo a strict qualification and
abide by the criteria before ultrasound
can be performed. Like in South Af-
rica, it is a big problem in Europe that
everybody can buy an ultrasound
machine and use it whether they are
qualified or not. I am glad to see that
Jack Jellins and his group are now
addressing this problem and I hope
to see positive developments emerg-
ing from this.