The talk I gave today was really a case based review, really focussing on the importance of high quality breast imaging, really emphasising the importance of high quality to allow accurate and early diagnosis of breast cancer. I gave a series of examples illustrating that to a large number of radiologists from Egypt. The feedback was really amazing, it was really well attended and it’s something that is very important and I heard that loud and clear.

What messages were you trying to communicate in this session?

One of the findings that I’ve seen in my experience is that sometimes the quality of the mammograms are done in a way that doesn’t include all of the breast tissue. It’s not recognised as poor quality and that means that we don’t include the cancers. I really was trying to emphasise the importance of high quality positioning to be able to permit that diagnosis. So we need to improve that education across not only Egypt but many other countries. So that was what I was really trying to convey.

What do you think the next steps are in implementing this education in places like Egypt?

What you’re doing here is actually a great idea, to be able to disseminate it on the web. It’s expensive for many radiologists to come here but if we use some of the tools that are available to us on the web this really helps disseminate that information in a much broader way.

Are there any barriers in terms of equipment?

I understand that actually it probably is an issue that the amount of equipment or the number of mammography units, for example, in Egypt is not what they’d like it to be. So it’s something to improve the awareness of the need for these machines and high quality imaging and that’s how you start is you demonstrate the benefit.

You also spoke about fast MRI, why is this technique so important?

Currently MRI right now is an extremely expensive tool, it typically takes 30 minutes for many centres to do one patient at a time. In women who are at the highest risk for breast cancer it may be the only diagnostic tool; it’s the most sensitive tool for breast cancer. So because it’s so expensive there is very limited access and we see in many countries, including Canada, that we don’t have enough access to breast MRI to make the diagnosis that really could help save a woman’s life.

So Christiane Kuhl published her results on doing an abbreviated MRI in 2014 which showed that you could reduce the time from 30 minutes to 3 minutes and you could actually be as accurate as a long MRI. So what we’ve done at the University of Ottawa is actually implement this in a randomised controlled trial for women who are breast cancer survivors and we’ve been able to show that the cancer detection rate using MRI was as high as 5% compared to the mammography where there was absolutely no cancer detection in these women. So what I wanted to share with the conference here is that it is feasible to do and that by doing a much shorter protocol you can actually increase the access and decrease the cost of the MRI to allow more patients to be done. That is the way that we have to do to improve some screening for women who are at higher risk for breast cancer to help reduce the poor outcomes in some of those women.

Anything you would like to add?

I think that it’s a real opportunity for us to collaborate. I definitely learn by coming to this meeting; I learn about how imaging is done of the breast in other countries. It really is an opportunity to share best practices and, not only that, to collaborate with friends from India, colleagues from Egypt, in the United States as well as meeting others from all over the world.