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AAPM 2025 - 67th Annual Meeting & Exhibition of the American Association of Physicists in Medicine

Women at High Risk of Breast Cancer May Benefit from Alternating Mammography and MRI

By MedImaging International staff writers
Posted on 20 Jan 2009

Magnetic resonance imaging (MRI) alternated with mammography at six-month intervals can detect breast tumors not identified by mammography alone, according to recent research.

A research team from the University of Texas M.D. Anderson Cancer Center (Houston, TX, USA) reported their findings in December 2008 at the CRTC-AACR (American Association for Cancer Research) San Antonio (TX, USA) Breast Cancer Symposium.

MRI is known to be more sensitive in detecting breast cancers than mammography, with a 71-100% accuracy compared to 16-40% accuracy for mammography. As a result, annual breast cancer screening for high-risk women now typically includes MRI scanning along with mammography and a clinical breast exam. "In the high-risk population, the recent standard of practice is to perform mammography and MRI every year,” said Huong Le-Petross, M.D., assistant professor of diagnostic radiology at M.D. Anderson and the study's first author. "What we started to do at M.D. Anderson was to see if we could do mammography and then six months later do a breast MRI exam, followed six months later with a mammogram exam, and then six months after that with a breast MRI. That way the women would receive an imaging modality screening every six months.”

In the pilot study, presented at the symposium, the researchers performed a retrospective chart review of 334 women who had participated in a high-risk breast cancer-screening program at M.D. Anderson from January 1997 to December 2007. The women had undergone between one and four MRI screening cycles and were considered to be at high risk if they had hereditary breast and ovarian cancer syndrome, a personal history of breast cancer, a biopsy indicating atypia or lobular carcinoma in situ (LCIS), or a 20% or higher lifetime risk of developing breast cancer, as estimated by the Gail model.

In the all-M.D. Anderson study, 86 of the 334 high-risk women (26%) underwent this alternating approach. Among this group, 46% completed the first round of MRI screening, 28% completed the second round, 13% completed the third round, and 4% completed the fourth round. The other 248 women underwent prophylactic mastectomy or were started on chemoprevention agents. All study participants were given a clinical breast exam every six months. The median follow-up time was two years, with a range of one to four years.

The alternating MRI- and mammography-screening program detected nine cancers among the 86 women: five invasive ductal carcinomas, three invasive lobular carcinoma, and two ductal carcinomas in situ. Five (55%) of these cancers were identified by MRI but not by mammography, three (33%) were found by both MRI and mammography, and one (11%) cancer, a tumor one millimeter in size, was overlooked by both screening techniques. No cancer was detected by mammography alone.

"We found that MRI picked up the majority of cancers, while mammography picked up only three out of the nine,” Dr. Le-Petross noted. With five of the eight cancers detected by MRI, the mammogram from six months earlier was either normal or suggested benign findings. "The global picture is that MRI can pick up cancers that mammography cannot,” Dr. Le-Petross said. "This would suggest that in this population it is more beneficial for the patient to have screening MRI so that we can pick up small lesions before a mammogram can detect them.”

One important unanswered question is whether an alternating MRI- and mammography-screening program will save lives. "That is going to take a five- to 10-year follow-up to determine,” Dr. Le-Petross added. "It is an exciting question because mammography has always been the standard, and now we are challenging that gold standard examination.”

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M.D. Anderson Cancer Center

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58 (97.990036010742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721752 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721752 AND published='1' LIMIT 1

59 (96.08268737793): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721752 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721752 AND published='1' LIMIT 1

60 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721752 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721752 AND published='1' LIMIT 1

61 (116.82510375977): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

62 (536.91864013672): SELECT fid FROM jos_deeppockets WHERE id=294721752 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294721752 AND published='1' LIMIT 1

63 (355.00526428223): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`

64 (58.174133300781): select jos_twitters.link from jos_twitters where cat=10

65 (30.040740966797): select jos_facebook.link from jos_facebook where cat=10

66 (46.014785766602): select jos_google_plus.link from jos_google_plus where cat=10

67 (46.014785766602): select jos_linkedin.link from jos_linkedin where cat=10

68 (55.789947509766): SELECT fid FROM jos_deeppockets WHERE id=294721752 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294721752 AND published='1' LIMIT 1

69 (35.04753112793): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`

70 (266.07513427734): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294721752 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (211.95411682129): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294721752 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (37.193298339844): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (73.909759521484): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (49.829483032227): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (39.815902709961): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (108.00361633301): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294721752 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (40.054321289062): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294721752 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (39.100646972656): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (49.829483032227): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (42.200088500977): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (87.976455688477): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721752 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721752 AND published='1' LIMIT 1

105 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721752 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721752 AND published='1' LIMIT 1

106 (48.160552978516): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294721752 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (46.968460083008): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294721752 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (77.962875366211): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721752 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721752 AND published='1' LIMIT 1

109 (82.015991210938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721752 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721752 AND published='1' LIMIT 1

110 (47.922134399414): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294721752 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (458.0020904541): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294721752 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (746.9654083252): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (438.92860412598): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (109.19570922852): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721752 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721752 AND published='1' LIMIT 1

115 (132.79914855957): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721752 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721752 AND published='1' LIMIT 1

116 (65.088272094727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721752 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721752 AND published='1' LIMIT 1

117 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721752 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721752 AND published='1' LIMIT 1

118 (87.02278137207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721752 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721752 AND published='1' LIMIT 1

119 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721752 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721752 AND published='1' LIMIT 1

120 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721752 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721752 AND published='1' LIMIT 1

121 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721752 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721752 AND published='1' LIMIT 1

122 (376.93977355957): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 23290.157318115): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (760.07843017578): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294721752 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294721752 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 9936.0942840576): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (113.96408081055): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (351.90582275391): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (58.174133300781): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (251.05476379395): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (54.836273193359): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (196.93374633789): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (41.961669921875): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (189.06593322754): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (50.067901611328): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (628.94821166992): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721752 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (504.97055053711): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721752 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (321.86508178711): SELECT name FROM jos_deeppockets WHERE id=212

138 (51.021575927734): SELECT name FROM jos_deeppockets WHERE id=212

139 (813.00735473633): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (711.91787719727): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (105.14259338379): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721752 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721752 AND published='1' LIMIT 1

142 (78.201293945312): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721752 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721752 AND published='1' LIMIT 1

143 (!!!!! 11292.934417725): TRUNCATE TABLE jos_trademed_module

144 (104.90417480469): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294721752 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (59.127807617188): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294721752 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (564.8136138916): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721752 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721752 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721752 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721752 AND published='1' LIMIT 1

149 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721752 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721752 AND published='1' LIMIT 1

150 (!!!!! 1559.9727630615): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (97.036361694336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721752 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721752 AND published='1' LIMIT 1

152 (69.141387939453): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721752 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721752 AND published='1' LIMIT 1

153 (73.909759521484): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294721752 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294721752 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (51.975250244141): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

155 (43.869018554688): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

156 (59.843063354492): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (192.88063049316): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721752 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721752 AND published='1' LIMIT 1

158 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721752 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721752 AND published='1' LIMIT 1

159 (95.844268798828): select jos_twitters.link from jos_twitters where cat=10

160 (32.186508178711): select jos_facebook.link from jos_facebook where cat=10

161 (35.04753112793): select jos_google_plus.link from jos_google_plus where cat=10

162 (33.140182495117): select jos_linkedin.link from jos_linkedin where cat=10

163 (403.88107299805): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (!!!!! 1354.9327850342): insert into jos_banners_delta values (14615,'2025-06-29 19:53:11','216.73.216.249','view'),(14202,'2025-06-29 19:53:11','216.73.216.249','view'),(14203,'2025-06-29 19:53:11','216.73.216.249','view')

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