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“When You Come to a Fork in the Road, Take It” Yogi Berra in Breast Care

Mark Koeniguer – CCO & President USA – Published on June 28, 2018

You may not be familiar with Yogi Berra, a famous American baseball player, but you may have heard some of his famous quotes and even the claim that a cartoon character, Yogi Bear, was inspired by him.

One of his famous quotes, “When You Come to a Fork in the Road, Take It,” referred to the best way to get to his house. It didn’t matter which direction you took, you would still find your way.

How is that related to Volpara Solutions and breast care? We are taking three different paths in the road, but they all lead to one point: building your breast care team to be their very best so that more lives are saved, allowing patients and their families to thrive.

Our work is all about supporting people: the breast care team, the patients and the patient’s family. Our three roads provide the care team with the tools they need to improve mammogram quality and make cancer detection easier:

1. “Personalised Care” Highway. Providing personalised care is our starting point. We help radiologists by providing an objective, automated breast density assessment, eliminating the variability introduced by imaging systems and processing from different vendors. Easily determining the breast density, and identifying patients with dense breasts, helps radiologists and physicians provide the personalised care patients need by referring them to additional imaging and/or risk counselling. It is now well known that dense tissue can mask abnormalities and can eclipse all other known breast cancer risk factors.1, 2, 3 Plus, in the United States, informing women of their breast density is now a requirement in 34 of 50 states. In Europe, new efforts are being made to educate not only patients but the medical community about the importance of breast density.

2. “Quality and Compliance” Boulevard. Our next path focuses on helping technologists advance their skills by providing access to a comprehensive, objective and automated assessment of image quality for every mammogram. Technologists can review their positioning, dose and compression quality, and access educational materials on how to improve areas of deficiency. Poor positioning can result in an 18-percent decrease in sensitivity.4 Poor compression can affect the dose delivered to the patient, patient discomfort and cancer detection rate.5 Ultimately, these factors could result in a technical recall, affecting the patient experience and increasing costs.

There is also a side benefit: the data is searchable, making it easy to conduct reviews and find the information needed to meet compliance requirements.

3.  “Decision Support” Drive. Our third road sees us moving to delivering density, positioning, dose and compression metrics at the point of care, so the technologist can make a timely decision about repeat imaging acquisition. This will reduce costs, save time, enhance the patient experience and immediately provide the radiologist with high-quality images.

Three paths, one destination: supporting the breast care team and their patients in the fight against breast cancer.


1. Destounis et al., Quantifying the potential masking risk of breast density in mammographic screening. Proceedings of the Radiological Society of North America 2015 Scientific Assembly and Annual Meeting, November 29 – December 4, 2015

2. Chan et al., Volumetric breast density assessment and mammography sensitivity. Poster presented at the 7th International Workshop on Breast Densitometry and Cancer Risk Assessment, June 10-12, 2015, San Francisco, CA

3. Engmann, et al, Population-Attributable Risk Proportion of Clinical Risk Factors for Breast Cancer; JAMA Oncol. 2017;3(9):1228-1236

4. Talpin SH et al, Screening Mammography: Clinical Image Quality and the Risk of Interval Breast CancerAJR:178, April 2002

5. Holland et al. Performance of breast cancer screening depends on mammographic compression, 2016