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Ryan Polselli
My name is Ryan Polselli. I am a breast imaging radiologist. Welcome to my site!
My name is Ryan Polselli. I am a breast imaging radiologist. Welcome to my site!

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Introducing my bottle opener collection

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Does someone with a breast fibroadenoma surgery carry higher risk of breast cancer? by Ryan Polselli

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Yep - that's all you have to do.


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My family has a history of breast cancer (great grandma, grandma, etc). Is there any test to find … by Ryan Polselli

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The 3D mammogram on the right shows the breast cancer much better than the regular digital mammogram on the left.

#radiology #breastcancer #mammography #mammogram #tomosynthesis #3dmammogram #reddit

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This was a magical experience.
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This summer has been amazing. Miranda and I picked up a new hobby...bicycling. We watched Blayke graduate college from the University of Florida and could not be more proud of him. I bought Miranda a new car...something she has been deserving for a while. We have been enjoying some great food on the grill at home and at some good restaurants. And most importantly...we have been spoiling our dog Piper who is a continual source of joy in our lives.
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I am excited to see newer forms of percutaneous preoperative breast lesion localization making their way into clinical practice. Although effective, the traditional preoperative needle localization procedure suffers from a couple of important limitations.

First, the wire must be inserted on the day of the procedure, most often immediately before surgery. This often creates a rate-limiting step for the patients progressing through the pre-surgical workup and radiologist are often rushed to meet the needs of the surgical team. This is a source of latent errors. In one particular instance I witnessed this "time crunch" from an impatiently waiting surgeon contribute to the wrong lesion being localized and excised. I am sure I am not the only radiologist who has witnessed a mistake due to the time sensitive nature of this procedure.

Second, at best a single wire is left hanging out of the breast with an awkward tape-job or sometimes even a styrofoam cup taped to the patient's chest wall in order to keep the wire out of the way and from becoming dislodged prior to surgery. In patients with a more complicated surgery requiring more than one wire to plan the surgical approach, it can leave the patient looking like some awkward form of radiofrequency receiver. Both cases leave the patient feeling uneasy, sometimes even grossly nauseated while looking at their breast with wires "hanging out" of it prior to surgery. Quite simply it looks and feels "barbaric."

About 9 months ago I discussed the potential benefits of a newer device (I have no significant relationship with the device manufacturer or marketers) called the Savi Scout. 3 days ago, original research was published in the journal Radiology that examined the effectiveness of this device used in 100 women over the course of a year and showed that it was effective for localizing lesions and bracketing lesions in as little distance as 2.6 cm.

See the article: Beyond Wires and Seeds: Reflector-guided Breast Lesion Localization and Excision.

I think the time is right for the breast imaging and surgical community to start seriously considering advancing clinical practice patterns by using this device in the interest of safety, patient comfort, and a level of convenience compatible with the modern day practice of medicine.

Ryan Polselli, M.D.
Fellowship Trained, Breast Imaging Radiologist

The most common way surgeons remove breast cancer seen on mammograms is by having the radiologist place a sharp wire into the breast, leaving it to stick out of the skin until the surgery.

This is very uncomfortable for patients and often looks and feels "barbaric."

Placing radioactive tracers into the breast cancer has been an alternative but still problematic due to the radiation restraints. This new option may help solve these problems.

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