The rotator interval and long head biceps tendon: anatomy, function, pathology, and magnetic resonance imaging

The rotator interval is an anatomically defined triangular area located between the coracoid process, the superior aspect of the subscapularis, and the anterior aspect of the supraspinatus. It is widely accepted that the rotator interval structures fulfill a role in biomechanics and pathology of the glenohumeral joint and long head biceps tendon. However, there is ongoing debate regarding the biomechanical details and the indications for treatment. A better understanding of rotator interval anatomy and function will lead to improved treatment of rotator interval abnormalities, and guide the indications for imaging and surgical intervention.     

Patients’ Perception of Care During Image-Guided Breast Biopsy in a Rural Community Breast Center Communication Matters

This retrospective study surveyed women about their experience with image-guided breast biopsies in a rural cancer center. Our study objectives were to determine: women’s perception of their emotional and physical comfort during the biopsy; the clarity and acceptability of the communication about the biopsy, as well as the methods used to provide the results of her biopsy and treatment options; and the overall impressions of the technical and personal care she received. A single mailed survey of 500 biopsy patients. The response rate was 43% (n = 215). Prior to their biopsy, 22% had been concerned that the biopsy would be painful and 43% were concerned that the biopsy might show cancer. Almost all women rated the communication about the biopsy procedure as understandable (99%) and accurately reflecting their experience (99%.) Most (77%) patients characterized the biopsy as producing minimal discomfort, although 5% disagreed. Most patients (98%) characterized their physician and technologists as caring about their emotional and physical comfort. Most patients felt that the typical 1-day wait to receive the results of their biopsy was reasonable (90%) and that the use of the phone to convey the results was acceptable (90%). On comparing patients with a diagnosis of cancer to those without, there was no difference in the level of satisfaction with the use of the phone to communicate biopsy results. This study offers encouragement that communication practices can alleviate the anxiety of women undergoing image-guided breast cancer biopsies.     

Adherence to screening mammography among American Indian women of the northern plains

Breast cancer is a burden for American Indian (AI) women who have younger age at diagnosis and higher stage of disease. Rural areas also have had less access to screening mammography. An Indian Health Service Mobile Women’s Health Unit (MWHU) was implemented to improve mammogram screening of AI women in the Northern Plains. Our purpose was to determine the past adherence to screening mammography at a woman’s first presentation to the MWHU for mammogram screening. Date of the most recent prior non-MWHU mammogram was obtained from mammography records. Adherence to screening guidelines was defined as the prior mammogram occurring 1–2 years before the first MWHU visit among women >41 years, and was the main outcome, whereas, age and clinic site were predictors. Adherence was compared with national data of the Breast Cancer Surveillance Consortium (BCSC). Among 1,771 women >41 years, adherence to screening mammography guidelines was 48.01 % among >65 years, 42.05 % among 50–64 years, 33.43 % among 41–49 years, and varied with clinic site (25.23–65.93 %). Age (p < 0.0001) and clinic site (p < 0.0001) were associated with adherence. Overall, adherence to screening mammography guidelines was found in 39.86 % (706/1771) of MWHU women versus 74.34 % (747,095/1,004,943) of BCSC women. The majority (60.14 %) of women at first presentation to the MWHU had not had mammograms in the previous 2 years, lower screening adherence than nationally (25.66 %). Adherence was lowest among women ages 41–49, and varied with clinic site. Findings suggest disparities in mammography screening among these women.