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Ryan Polselli
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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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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. http://dx.doi.org/10.1148/radiol.2017161661

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

#saviscout
#needlelocalization
#reflectivemarker
#lumpectomy
#breastcancer
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.

#breastcancertreatment
#wirelocalization
#wireguidance
#lumpectomy

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Miranda and I took a short detour during our last business trip to Arizona to spend a few days in Sedona and enjoyed some breathtaking views. What a beautiful area.
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4/10/17
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I was very moved by what I experienced at the PGA Valspar Championship yesterday. People from all walks of life came together for an experience that was remarkably absent of political and social fighting.

Smiles were everywhere, laughter filled the air, and I witnessed numerous random acts of kindness. I watched high school parents working hard serving beer for tips all day to donate to their local high school. I watched thousands of people donate hard earned money to Habitat for Humanity. I saw people give up their seats and holding places for strangers in line. In short, I saw people taking care of each other.

Despite my experiences of the real tragedy that exists in this world and the tough work we still have to do to purge the bad eggs from our society, at least yesterday I was reminded of the goodness in human nature...and it gave me hope and filled my soul with joy.
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3/12/17
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This is great news from an article in Radiology Business!

New York, Texas, New Jersey, New Hampshire, and Maryland are introducing legislation to require coverage for Digital Breast Tomosynthesis aka DBT (better known as 3-D Mammograms).

Breast cancer screening is usually a non-partisan issue (yes, there is one!), and generally well received by legislators. I expect that in the future, 3-D mammograms will be covered across the board in the United States.

#breastcancerscreening
#breasttomosynthesis
#3dmammogram
#dbt
#mammolink


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This is not a surprising result from this study originally published in Radiology.

There is no question that breast MRI is a very sensitive test for the detection of breast cancer...probably more sensitive than mammography in a lot of cases.

But it's significantly longer, requires an IV for contrast (newer techniques without contrast are being developed), and in the current system, and has a tendency to lead to more false positive biopsies (especially if not interpreted by a specially trained breast imaging radiologist who is an expert in breast MRI).

Overall however, all of these considerations are being appropriately addressed and I do believe that breast MRI is a very useful tool that is significantly underutilized (insurance hates paying for these and many doctors are understandably uncertain about how to best use this evolving technology).

In the future, however, there is no question in my mind that breast MRI will become part of the natural vocabulary in the educated patient and increasingly play a big role saving the women in our lives.

Ryan Polselli, M.D., Breast Imaging Radiologist

#breast MRI
#breastcancer
#radiology
#breastcancerscreening

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In healthcare, we are often so busy "treating" that we forget about "communicating" and it is my opinion that the healthcare community needs to significantly improve communication with patients.

One of the things that we are doing at MammoLink® is creating a newsletter to keep our patients, physicians, staff, and breast cancer community in general updated and informed.

We just finished creating our signup form for the newsletter this morning and made the forms available on twitter and Facebook. In the next few weeks, we will make them available on our website (mammolink.com) and other locations.

#MammoLink

http://eepurl.com/cBB1Jn

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Our article was featured in the Digital Pathology Blog with insightful comments from Dr. Keith J. Kaplan. I do believe that the model (as the question was raised by Dr. Kaplan) will undoubtedly lead to more effective breast cancer detection than we have seen in the past. With some help from my colleagues in the academic community I hope we will be able to prove this.

#MammoLink

http://tissuepathology.com/2017/01/31/breast-imaging-company-mammolink℠-rings-in-the-new-year-with-bold-predictions/#axzz4YCKd4O00

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I have been asked about the #MammoLink installation process, so I thought it would be useful to post a couple of actual photographs from a recent mammography unit installation demonstrating what the typical plans look like and what the patient room will look like as a unit is being installed. The full post is on Facebook.

https://www.facebook.com/hashtag/mammolink?source=feed_text&story_id=1657638690916592

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MammoLink℠ is now officially MammoLink®!

Approximately 7 months ago we began the journey of obtaining registered trademark status for #MammoLink and we were notified earlier today that our request was officially granted by the U.S. Patent and Trademark Office.

Mark Smiley (our attorney) and Mark Woodruff from the Concept Law Group were incredibly efficient, professional and a pleasure to work with. I am extremely grateful for their work.

#mammogram
#mammography
#breastcancerscreening
#breastimaging
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Miranda and I were up late tonight working hard to create some final content and put some finishing touches on our website for #MammoLink which will be released soon. The soon to be released final product looks amazing. After researching several web design companies about 6 months ago we chose SEO Brand and we could not be happier with our decision. This company is professional, hard working, and VERY good at what they do. We are very grateful for what they have been able to accomplish this far. We cannot wait to reveal the site! There is a sneak peek of a screenshot on our MammoLink Company Facebook page.

#mammogram
#mammography
#breastcancerscreening
#3-Dmammogram
#breasttomosynthesis
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