Search

Mammography will continue as the breast cancer screening imaging study of choice for the foreseeable future. Ultrasound and magnetic resonance imaging (MRI) are widely available adjunctive studies for women with suspicious mammographic or clinical findings, and MRI is a screening tool for women with specific increased risks for breast cancer. Options for diagnosis will continue to evolve and progress. This article discusses a wide variety of imaging options currently used and in development, their strengths, limitations, and potential future roles in the continuing pursuit of early breast cancer diagnosis, treatment, and follow-up.

A common endeavor shared by physicians practicing in specialty fields of Radiology and Obstetrics and Gynecology is the comprehensive care and diagnosis of women with breast problems and breast disease. Because each specialty provides its respective clinical expertise in breast health, each also shares a concern, which is the high risk of litigation associated with a missed or delayed diagnosis of breast cancer. This shared concern is well documented for both specialties. Instead, it is argued that physicians are better prepared by engaging in the practice of evidence-based breast care in their respective specialties.

The following topics are discussed in this article. A historical review of the evolution of breast cancer imaging from thermography through digital breast tomosynthesis, molecular breast imaging, and advanced breast magnetic resonance imaging. Discussion of multiple clinical trials, their strengths, and weaknesses. Historical perspective on the Mammography Quality Standards Act and its relationship with development and implementation of the Breast Imaging-Reporting and Data System (BI-RADS).

Many clinical approaches assume that the development of new stories or narratives is at the heart of therapeutic change. But why is it often so difficult for clients to modify the stories that organize their lives? Why do new insights gained in therapy fade so quickly when clients return to their daily living? Provocative new neurological research suggests that self-defeating narratives may persist because they are woven into the fabric of internal states which are automatically activated in daily living, often without conscious awareness. New brain studies suggest that, for changes acquired in therapy to last, they must be integrated into brain states that become active when upsetting situations occur. This paper introduces methods for helping clients identify internal states which perpetuate outmoded thoughts, attitudes, and interactions, “re-wire” these states for more flexibility, and activate alternate states which support new avenues for thought and action.

A common endeavor shared by physicians practicing in specialty fields of Radiology and Obstetrics and Gynecology is the comprehensive care and diagnosis of women with breast problems and breast disease. Because each specialty provides its respective clinical expertise in breast health, each also shares a concern, which is the high risk of litigation associated with a missed or delayed diagnosis of breast cancer. This shared concern is well documented for both specialties. Instead, it is argued that physicians are better prepared by engaging in the practice of evidence-based breast care in their respective specialties.

Funding for this research was provided by the National Science Foundation (SES 800 8570) and the Program on Nonprofit Organizations, Yale University. We would like to thank Denise Cobb for her assistance in typing the manuscript and an anonymous ASQ reviewer for his or her insightful comments. This paper examines the effect of ownership patterns on corporate contributions to charity and corporate beliefs rationalizing contributions. The study uses data and findings from an earlier study of the Twin Cities corporate grants economy and new data on 69 publicly held firms headquartered in Minneapolis-St. Paul to test hypotheses derived from agency theory about corporate giving. Controlling for pretax income, proximity of the company's executives to the local philanthropic elite, and the rationale used to justify contributions, we found that companies gave less money to charity in 1979-1981 if the CEO or some other individual owned a significant percentage of stock in the company. In contrast, the percentage of stock owned by a single corporate interest or family group had no effect on company contributions. Social proximity of executives to the local philanthropic activists had a positive effect on contributions, except when a family group owned more than 5 percent of the company's stock. We explore the implications of our findings from the perspective of agency theory and business policy.'