Original articleThe ACR/Society of Breast Imaging Resident and Fellowship Training Curriculum for Breast Imaging, Updated
Introduction
The first resident and fellow curriculum, created by the Society of Breast Imaging (SBI), was published in 2000 [1]. That curriculum focused, appropriately, on film-screen mammographic techniques as the main imaging approach. Ultrasound was included, as was ultrasound-guided breast biopsy. Cyst aspiration was listed, but so was pneumocystography. Stereotactic biopsy was widely available but in a slightly different form than we know today. Both written and oral board examinations were given during the fourth and final year of residency training. The curriculum was thorough and timely for breast imaging practice at the beginning of the 21st century.
Since that time, breast imaging practice has changed and expanded. Digital mammography and breast MRI were not used as they are today. Pneumocystography is gone. Stereotactic biopsy is now often done with vacuum assistance. Molecular imaging is evolving. Mammography Quality Standards Act updates have occurred. Some of these changes were evident midway through the first decade of the 21st century and were covered in the first update to this curriculum. That update was constructed in conjunction with the ACR Commission on Breast Imaging as a joint document [2]. It streamlined the curriculum overall and updated it to reflect the breast imaging educational needs that existed in 2006. Still, breast imaging practice continues to advance and evolve. This curricular update attempts to address this progression. A writing team, consisting of members of the education committees of both the SBI and the ACR Commission on Breast Imaging, reviewed and updated the curriculum. The new updated SBI/ACR Breast Imaging Residency Training Curriculum is shown in its entirety in Table 1, available online at http://dx.doi.org/10.1016/j.jacr.2012.07.026 [3, 4, 5, 6, 7, 8, 9, 10, 11, 12]. The major additions and changes as well as significant stable points of emphasis are summarized in the following discussion.
Section snippets
Discussion
A reasonable knowledge of breast anatomy, physiology, and pathology is required, as in earlier iterations of the breast imaging training curriculum. In the new curriculum, the pathology section has been expanded. Knowledge of regional lymph node anatomy and drainage patterns is recommended because of the increased involvement of breast imagers in assessing nodal disease, especially with needle biopsy. Benign breast diseases are better outlined to include new terminology, such as columnar cell
Summary
The education committees of the ACR Commission on Breast Imaging and the SBI have provided this updated curriculum in an attempt to keep pace with our ever changing subspecialty. Full-field digital mammography is now fully in mainstream use, and this is reflected in the document. MRI use has expanded, and genetic testing and counseling are more prevalent. As advances are made in imaging the breast, further revisions will be needed and expected. This updated curriculum attempts to address the
Take-Home Points
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The education committees of the ACR Commission on Breast Imaging and the SBI have updated the resident and fellowship training educational curriculum for breast imaging.
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The new curriculum takes into account changes in breast imaging practice since the last curriculum was published in 2006, such as the widespread use of digital imaging in mammography, the increased use of breast MRI in breast diagnosis, and changes in the examination process.
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The curriculum is intended to provide guidance to
Acknowledgments
Our thanks to the following individuals who reviewed and approved the overall curriculum: Barbara Monsees, MD, chair of the ACR Commission on Breast Imaging; Debra M. Ikeda, MD, Carol H. Lee, MD, and Brett Parkinson, MD, of the ACR Commission on Breast Imaging Education Committee; and W. Phil Evans, MD, Mark A. Helvie, MD, Elizabeth A. Morris, MD, and Eric I. Rosen, MD, of the SBI Board of Directors.
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Dr Appleton is a speaker and consultant for Hologic, Inc (Marlborough, Mass), receives funding as an expert witness, and receives royalties from Oxford University Press (Oxford, United Kingdom). Ms Butler is employed by the ACR and has worked on the quality control manuals mentioned in this article.