DVD'S ASSESSMENT

The DVD-ROM "Breast Cancer, a Team Approach" is accredited for 40 credits by the University of Montreal (co-provider) and approved by the Canadian Association of Radiologists (chapter of ACR) towards the American Medical Association for AMA PRA category 1 (agreement between Canadian university CME offices, CACME (Accreditation Council for CME) in Canada and ACCME (Accreditation Council for CME) in the USA for substantial equivalence, the Royal College of Physicians and Surgeons of Canada through Section 4 of the Maintenance of Certification Program, and FEPUR in France for SFR category 2. CME activity planned in accordance with CACME and ACCME Essentials. The CD-ROM "Breast Cancer, a Team Approach" has been objectively and independently evaluated by many experts in breast cancer including Dr Laszlo Tabar and Dr Lawrence W. Bassett as consultants on explicit request of the Canadian Association of Radiologists (CAR) and the CPD Head Office of the Universite de Montreal. Eighth Edition now available (NEW Edition)

Reviews:

  Complete evaluation of the 6th edition (2005) by Drs Silvia Jaromi and Thomas H. Helbich (Vienna, Austria).

   Overview of the novelties.

   Dr Laszlo Tabar’s assessment, Uppsala Sweden (4th Edition).

   Dr Harry J, Griffiths' Assesment for "Radiographics", USA (5th Edition).

   Dr Lawrence W. Bassett's assessment, UCLA, USA (5th Edition).

   Dr Samuel Merran's assessment, France (3rd Edition).

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Complete evaluation of the 6th edition (2005) by Drs Silvia Jaromi and Thomas H. Helbich (Vienna, Austria).
by Drs Silvia Jaromi and Thomas H. Helbich (Vienna, Austria) which was published in the European Journal of Radiology, Vol. 59, N. 1, p. 123, section "Book Review", July 2006.

Breast cancer is the most frequently diagnosed cancer, accounting for 30% of all new cancer each year among women, and is the second leading cause of mortality by cancer in Canada and the USA. Despite recent controversies over its usefulness, especially in women under age 50 years, mammography is still considered to be the gold standard for early detection of breast cancer.

This DVD-ROM entitled "Breast Cancer, A Team Approach" correlates mammography, pathology and nuclear medicine. Experienced contributors enhance this brilliant work by their respective expertise. Their knowledge is most valuable in providing a general, practical, and scientific understanding of breast cancer.

The DVD contains a self-assessment program on breast cancer and is designed for Continuing Medical Education (CME), approved by the Canadian Association of Radiologists and the University of Montreal. It meets the standards for accredited self-assessment programs of the Royal College of Physicians and Surgeons of Canada. The primary audience is general radiologists, but also pathologists, nucleists, surgeons, and general practitioners with a family practice dedicated to women’s care.

Practical cases have been meticulously selected to cover a wide range of clinical situations. The DVD reviews the diagnostic and therapeutic aspects of breast cancer, including the relevant literature. It is presented in an interactive and autodidactic way. Content is presented in English and French.

The disk is divided in eight parts. The 1st part consists of 22 sections. The early sections contain introductions of collaborators, learning objectives, contents of the DVD, and maintenance of certification. The next sections address the anatomy of the breast, breast cancer epidemiology, including statistical data of Canada and the USA, recommendations and importance or quality assurance programs in Canada, USA, United Kingdom, and European Countries. Relative and theoretical risks of developing breast cancer are covered in the next sections, followed by an overview of future perspectives, including digital mammography and magnetic resonance imaging.

The subsequent section illustrates the classification and clinical stages of breast cancer, followed by a section on nuclear medicine in breast imaging. The BI-RADS classification is outlined and includes definitions as well as management of the seven categories. Various aspects of pathology of breast cancer including Ductal Carcinoma in Situ, Infiltrating Ductal Carcinoma, Lobular Neoplasia, and Infiltrating Lobular Carcinoma are accurately described.

Several sections discuss topics ranging from clinical findings of breast cancer to treatment, to prognosis, and to indications and intervals for screening and diagnostic mammography. The final section contains the mammographic criteria for abnormalities, schematized in synoptic charts, including flow charts for work-up and management of these abnormalities.

Parts 2, 3 and 4 consist of clinical cases of benign and malignant disease. Each case begins with a clinical history followed by radiologic images (mammograms, ultrasonography, nuclear scans) and histology.

The viewer can click on areas of abnormal findings to open a window containing descriptions and recommendations, including magnification views. The user is then asked to give a BI-RADS diagnosis and recommendations for further treatment. Then, if biopsy specimens from

the lesions are obtained, the user can view pathologic images, which are of excellent quality, both technically and pedagogically.

Part 5 consists of two different tests, one being an interactive test with "True or False", and the other an interactive clinical quiz to involve the participant in diagnostic and therapeutic decisions.

Part 6 and 7 contain the multiple choice test to merit CME credits. They explain how to participate to the CME test and how to obtain participant’s score, an evaluation of answers, and a Certificate of Participation.

Part 8 is an outstanding summary of breast MRI, including an excellent overview of the technicalities of MRI and in addition contains the ACR breast MRI lexicon. Further, sensitivity, specificity, potential applications as well as limitations of MRI are discussed.

Breast Cancer? A Team Approach is very user friendly. It is easy to follow the complex scientific material and thus represents a highly valuable teaching tool. The content is well organized, abundantly illustrated, and includes all important aspects of breast cancer. This DVD-ROM should be part of every radiologist’s DVD shelf or any physician interested in breast imaging and breast cancer.

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Overview of the novelties.

• Technical improvement with newer menus, indexes and hypertext links.  A user-friendly DVD to make the complex scientific material even easier to follow.

• Existing scientific content upgraded for an up-to-date edition. Literature has been reviewed, texts accompanying mammographic, ultrasonographic and histopathologic images have been heightened to meet the best standards.

• All sisty original charts reviewed and reformatted with newer synoptic charts.

• New relevant epidemiologic and statistic data including charts on incidence and mortality rates, probability of breast cancer among the American population, and much more.

• New interesting clinical cases in Part 5, section ‘’Interactive Clinical Quiz’’.

• New chapter in Part 1 with easy to use flow charts describing the proper workup and management of asymmetric density, masses, cystic lesions and microcalcifications including BI-RADS®.

• New chapters on histopathology depicting more explicitly the histology of DCIS, LCIS, infiltrating ductal carcinoma and infiltrating lobular carcinoma.

• New chapter on ‘’Gradation of Histologic Risks’’ with easy to understand charts and histologic images.

• New descriptive texts related to scintimammography, sentinel lymph node and FDG-PET techniques in nuclear medicine.

• Assessing post biopsy concordance between imaging and histology with management (8th edition).

• New chapter to review digital technologies (8th edition).

• New chapter to heighten ‘’Diagnostic Acuity and Perception’’: training with new digital clinical cases (8th edition).

• New interactive quiz on how to detect and analyze microcalcifications (8th edition).

• New DVD-ROM: 4 GB, 3000 pages, 60 original charts, management flow charts, digital imaging!

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Dr Laszlo Tabar’s assessment, Uppsala Sweden (4th Edition).

Dear Dr Couture (and colleagues),

I would like to congratulate you and your colleagues for the idea and execution of this brilliant didactic material since the DVD you have created deserves attention. It is very user-friendly, easy to follow the complex scientific material, a real good teaching tool. I am sure that many colleagues will learn a great deal of it and that was the primary purpose of producing it. You have so much to offer for the colleagues out in the field.

Altogether, my opinion is that you and your team have done a superb job, everybody who will look at it will understand the amount of work you and your team have put into producing this very valuable teaching tool.

With kindest regards,

Dr Laszlo Tabar, MD

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Dr Harry J, Griffiths' Assesment for "Radiographics", USA, Volume 25, Number 3, May-June 2005, p.658, 5th edition

Here is an excerpt of the evaluation:

The content covers all facets of breast imaging. The disk is divided in two parts. The first presents basic, theoretical, and statistical information for topics ranging from anatomy to cancer classification to quality assurance. The second consists of clinical cases of benign and malignant disease and self-assessment tools. Altogether I enjoyed viewing this DVD. It is more comprehensive that it initially appears, and it covers nearly all aspects of mammography and breast cancer. I would recommend the DVD to anyone interested in breast imaging and breast cancer.

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Dr Lawrence W. Bassett's assessment, UCLA, USA, 5th edition

Dr Lawrence W. Bassett from UCLA enthusiastically reviewed, as an independant expert consultant, the scientific content of the DVD-ROM, particularly the BI-RADS® Categories of the ACR. Some of his comments are following.

"It looks great". "I enjoyed the cases". "It was fun because it included a lot of management decisions". "Applauses."

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Dr Samuel Merran's assessment, France, 3rd edition

Dr Samuel Merran, redaction's director of « SFRNET magazine » in France has evaluated the 3rd edition (the 5th edition is enhanced by 150% relatively to the 3rd edition).He wrote in Vol.1, No 1, January 2003 (translation):

"This DVD is a model of its kind. The content is perfectly structured, abundantly illustrated and includes all the clinical information, the epidemiology, histology and radiological imaging of breast cancer". "Cases show clinical information, images of good quality, both technically and pedagogically speaking, with the final pathologic diagnosis to correlate". "This DVD should be part of every radiologist's DVD stand interested by breast cancer".

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