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Women Not Receiving Recommended Breast Screening MRI

By MedImaging International staff writers
Posted on 15 Feb 2012

A study of 64,659 women found that while 1,246 of these women were at high enough breast cancer risk to recommend additional screening with magnetic resonance imaging (MRI), only 173 of these women returned to the clinic within one year for the further screening.

The study’s findings were published in the January 2012 issue in the journal Academic Radiology. “It’s hard to tell where, exactly, is the disconnect,” said Deborah Glueck, PhD, an investigator from the University of Colorado Cancer Center (Denver, CO, USA) and associate professor of biostatistics and informatics at the Colorado School of Public Health, the article’s senior author.

But no matter the discrepancy, the result is unambiguous: women who should be getting breast screening MRI are not.

Along with her PhD student, John Brinton, Dr. Glueck got interested in the data of MRI breast screening soon after the 2007 recommendation by the American Cancer Society (Atlanta, GA, USA) that women at increased lifetime risk for developing breast cancer be screened with MRI in addition to annual mammograms. In fact, in spite of most major U.S. health insurances offering coverage, few clinics put the recommendation into practice.
An exception is Invision Sally Jobe Breast Centers (Denver, CO, USA). “The Invision Sally Jobe Breast Centers and our collaborators, Dr. Lora Barke, Mary Freivogel, and Stacy Jackson have been invaluable partners in our research,” Dr. Glueck said.

At Invision Sally Jobe, clinicians were using the US National Cancer Institute’s (Bethesda, MD, USA) Gail Model to identify a patient’s lifetime risk of developing breast cancer. For women with greater than 20% lifetime risk, the clinic included in the mammography findings that were sent to women’s primary care physicians a note explaining the elevated risk and suggesting that the physician refer high-risk women for the recommended MRI. “Did women never hear the recommendation from their physician? Did they choose not to follow through? Did they go elsewhere for an MRI? We don’t know,” Dr. Glueck remarked.

Thus, major questions remain in the assessment of the benefit, feasibility, and implementation of breast MRI screening. According to Drs. Glueck and Brinton, the most essential and all-encompassing of these questions is whether the benefits of MRI screening for women at high risk for breast cancer, in fact, outweigh its high financial, medical, and psychologic costs.
“For this to be true, first MRI has to catch breast cancer sooner than traditional mammography, it has to catch cancers that would otherwise kill, it has to catch cancers for which early treatment is more effective than later treatment, and the medical and psychologic downsides in the process of screening and follow-up care--for example, the potential for increased biopsies--have to be lower than the medical positives,” Dr. Glueck said.

Follow-up studies should help answer these questions, including a planned study in which the researchers will see if informing high-risk women directly about the breast screening MRI recommendation will improve screening adherence. However, considerable obstacles remain between the hypothesis that shows survival benefit for breast screening MRI in high-risk women and its practice, according to the investigators.

Related Links:
University of Colorado Cancer Center
Invision Sally Jobe Breast Centers

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61 (141.85905456543): 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 (460.86311340332): SELECT fid FROM jos_deeppockets WHERE id=294739306 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294739306 AND published='1' LIMIT 1

63 (98.943710327148): 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 (91.075897216797): select jos_twitters.link from jos_twitters where cat=10

65 (116.82510375977): select jos_facebook.link from jos_facebook where cat=10

66 (59.127807617188): select jos_google_plus.link from jos_google_plus where cat=10

67 (28.848648071289): select jos_linkedin.link from jos_linkedin where cat=10

68 (31.948089599609): SELECT fid FROM jos_deeppockets WHERE id=294739306 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294739306 AND published='1' LIMIT 1

69 (34.093856811523): 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 (398.15902709961): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294739306 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (222.20611572266): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294739306 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (48.87580871582): 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 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (32.186508178711): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (122.0703125): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (54.836273193359): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (50.067901611328): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294739306 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (30.994415283203): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294739306 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (34.093856811523): 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 (56.028366088867): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (74.148178100586): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739306 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739306 AND published='1' LIMIT 1

105 (60.081481933594): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739306 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739306 AND published='1' LIMIT 1

106 (61.988830566406): 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=294739306 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (51.975250244141): 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=294739306 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (85.115432739258): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739306 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739306 AND published='1' LIMIT 1

109 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739306 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739306 AND published='1' LIMIT 1

110 (58.174133300781): 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=294739306 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (468.01567077637): 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=294739306 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (630.14030456543): 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 (551.93901062012): 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 (82.015991210938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739306 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739306 AND published='1' LIMIT 1

115 (58.174133300781): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739306 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739306 AND published='1' LIMIT 1

116 (87.02278137207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739306 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739306 AND published='1' LIMIT 1

117 (84.161758422852): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739306 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739306 AND published='1' LIMIT 1

118 (64.849853515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739306 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739306 AND published='1' LIMIT 1

119 (54.836273193359): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739306 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739306 AND published='1' LIMIT 1

120 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739306 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739306 AND published='1' LIMIT 1

121 (48.160552978516): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739306 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739306 AND published='1' LIMIT 1

122 (344.99168395996): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 27334.928512573): 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 (596.04644775391): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294739306 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294739306 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 10264.158248901): ( 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 (94.890594482422): ( 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 (60.796737670898): 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 (40.054321289062): 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 (77.962875366211): 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 (43.869018554688): 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 (259.8762512207): 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 (56.982040405273): 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 (50.783157348633): 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 (37.193298339844): 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 (505.92422485352): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739306 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (355.00526428223): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739306 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (55.789947509766): SELECT name FROM jos_deeppockets WHERE id=212

138 (38.862228393555): SELECT name FROM jos_deeppockets WHERE id=212

139 (763.1778717041): 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 (676.87034606934): 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 (94.890594482422): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739306 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739306 AND published='1' LIMIT 1

142 (68.902969360352): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739306 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739306 AND published='1' LIMIT 1

143 (!!!!! 10493.993759155): TRUNCATE TABLE jos_trademed_module

144 (124.93133544922): 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=294739306 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (77.009201049805): 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=294739306 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (612.02049255371): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739306 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (74.863433837891): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739306 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (84.877014160156): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739306 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739306 AND published='1' LIMIT 1

149 (59.127807617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739306 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739306 AND published='1' LIMIT 1

150 (!!!!! 1584.0530395508): 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 (85.115432739258): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739306 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739306 AND published='1' LIMIT 1

152 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739306 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739306 AND published='1' LIMIT 1

153 (61.03515625): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294739306 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294739306 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (44.822692871094): 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 (43.153762817383): 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 (44.107437133789): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (97.036361694336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739306 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739306 AND published='1' LIMIT 1

158 (65.088272094727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294739306 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294739306 AND published='1' LIMIT 1

159 (46.968460083008): select jos_twitters.link from jos_twitters where cat=10

160 (36.001205444336): select jos_facebook.link from jos_facebook where cat=10

161 (38.862228393555): select jos_google_plus.link from jos_google_plus where cat=10

162 (42.200088500977): select jos_linkedin.link from jos_linkedin where cat=10

163 (388.14544677734): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (!!!!! 1607.1796417236): insert into jos_banners_delta values (14615,'2025-06-26 16:01:33','216.73.216.249','view'),(14202,'2025-06-26 16:01:33','216.73.216.249','view'),(14203,'2025-06-26 16:01:33','216.73.216.249','view')

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