Whitepaper: Training in Diagnostic and Interventional Breast Radiology

Abstract

Purpose Breast imaging represents an integral part of radiology and is subject to strict quality controls. Regarding this, precise diagnostics including multimodal assessment by mammography, sonography, and MRI, including image-guided biopsy and localization procedures, is often decisive and must be performed by experts with profound knowledge and skills in all of these procedures.

However, due to numerous restructurings, breast imaging has been shifted more and more towards large, specialized centers, resulting in less patient exposition and training opportunities for radiologists in smaller sites. The following whitepaper summarizes the current circumstances and discusses opinions of the participating societies.

Materials Under the leadership of the German Roentgen Society (DRG) and with the participation of the DRGʼs AG Mammadiagnostik, the CAFRAD (Chefarztforum Radiologie), the KLR (Konferenz der Lehrstuhlinhaber für Radiologie e. V.), the DRGʼs Forum Junge Radiologie (FJR) and the Berufsverband der Deutschen Radiologen e. V. (BDR), possible solutions were discussed and consented for a structured training in breast radiology in the future.

Results In addition to the teaching provided at the primary workplace, qualified training should be ensured through flexible, multi-institutional, interdisciplinary, and cross-sectoral collaboration. Furthermore, the integration of online case collections and close cooperation with certified breast cancer centers and mammography screening units is recommended. It is indispensible that online courses and case collections adhere to the standards of the national societies and include a maximum of one third of the required cases.

Conclusion In order to provide training in breast radiology at a high professional level, a paradigm shift with closer cooperation of all participants is necessary. This includes close collaboration of the breast imaging societies with the federal medical associations to establish new teaching concepts like e-learning in the training schedule of radiologists.

Key points 

• Breast diagnostics is an integral part of radiology training.

• Due to recent restructurings, smaller training centers have difficulties in meeting the case numbers demanded by the Specialist Training Regulations (WBO). Improved integration of the new structures and their adaptation to the needs of education are necessary to guarantee standardized high-quality training of young radiologists.

• The integration of certified case collections enables quality-assured training, even across regions in online-based formats. In accordance with the “blended learning principle”, up to one-third of the required number of patient studies can be substituted with cases from a certified case collection.

• Legally secured short- and medium-term internships may complement training in radiology.

Citation Format

• Sauer ST, Bley TA, Wenkel E et al. Whitepaper: Training in Diagnostic and Interventional Breast Radiology. Fortschr Röntgenstr 2023; 195: 699 – 706

Key words

breast imaging - e-learning - medical education - curriculum radiology - blended learning - training in breast radiology

Publikationsverlauf

Eingereicht: 26. August 2022

Angenommen: 19. April 2023

Artikel online veröffentlicht:
22. Juni 2023

• References

• 1 Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF). S3-Leitlinie Früherkennung, Diagnose, Therapie und Nachsorge des Mammakarzinoms, Version 4.4, 2021, AWMF Registernummer: 032-045OL. Zugriff am 02. April 2023 unter: http://www.leitlinienprogramm-onkologie.de/leitlinien/mammakarzinom
• 2 Lauby-Secretan B, Scoccianti C, Loomis D. et al. Breast-cancer screening- viewpoint of the IARC Working Group. International Agency for Research on Cancer Handbook Working Group. N Engl J Med 2015; 372 (24) 2353-2358
• 3 Forum Junge Radiologie. Weiterbildungscurriculum der DRG – Version 1.1. Zugriff am 02. April 2023 unter: https://www.forum-junge-radiologie.de/media/document/27982/Weiterbildungscurriculum-final-10-05-2021-V-1-1.pdf
• 4 European Society of Radiology. ESR European Training Curriculum Level I-II (2020). Zugriff am 02. April 2023 unter: https://www.myesr.org/sites/default/files/2020-03/ESR%20European%20Training%20Curriculum%20Level%20I-II%20%282020%29.pdf
• 5 Bundesärztekammer. (Muster-)Weiterbildungsordnung 2018 in der Fassung vom 25.06.2022. Zugriff am 02. April 2023 unter: https://www.bundesaerztekammer.de/fileadmin/user_upload/BAEK/Themen/Aus-Fort-Weiterbildung/Weiterbildung/20220625_MWBO-2018.pdf
• 6 Gesetz zum Schutz vor der schädlichen Wirkung ionisierender Strahlung (Strahlenschutzgesetz – StrlSchG), Artikel 1 G. v. 27.06.2017 BGBl. I S. 1966 (Nr. 42); zuletzt geändert durch Artikel 2 G. v. 20.05.2021 BGBl. I S. 1194, 2022 BGBl. I S. 15, Geltung ab 31.12.2018.
• 7 Richtlinie: Fachkunde und Kenntnisse im Strahlenschutz bei dem Betrieb von Röntgeneinrichtungen in der Medizin oder Zahnmedizin vom 22. Dezember 2005. Zuletzt geändert durch RdSchr. v. 27.6.2012 (GMBl 2012, S. 724; ber. S. 1204). 2012
• 8 Ruiz JG, Mintzer MJ, Leipzig RM. The impact of E-learning in medical education. Acad Med J Assoc Am Med Coll 2006; 81: 207-21
• 9 Sivarajah RT, Curci NE, Johnson EM. et al. A Review of Innovative Teaching Methods. Acad Radiol 2019; 26: 101-113
• 10 Liu Q, Peng W, Zhang F. et al. The Effectiveness of Blended Learning in Health Professions: Systematic Review and Meta-Analysis. J Med Internet Res 2016; 18: e2
• 11 Deutsche Röntgengesellschaft (DRG), ConRad Lernplattform. Zugriff am 02. April 2023 unter: https://academy.mevis.de/drg/courses/runVideo/1187/
• 12 Ärztekammer Schleswig-Holstein. Merkblatt Hospitationen/Rotation. Zugriff am 02. April 2023 unter: https://www.aeksh.de/sites/default/files/2022-07/merkblatt_hospitation_rotation.pdf