{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T06:18:11Z","timestamp":1787811491939,"version":"build-2784847793"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Health Serv."],"abstract":"\n Background<\/jats:title>\n Communication in diagnostic breast imaging remains a critical yet frequently neglected aspect of radiological training. Traditionally centered on technical image interpretation, radiological education often leaves practitioners unprepared to navigate the severe emotional and psychological burden of a suspected breast cancer diagnosis.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n This paper advocates for the communicative autonomy of the breast radiologist, arguing that direct, empathetic communication is not a secondary skill, but a core clinical act that directly influences both the psychological wellbeing and the physiological stress response of the patient.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We propose the\n CLEAR protocol<\/jats:bold>\n (\n Connect, Listen, Explain, Ask, Reassure<\/jats:italic>\n ), a transcultural framework conceptualized to bridge clinical rigor with human empathy. The model integrates plausible neurobiological pathways\u2014hypothesizing that non-verbal semiotics may influence HPA-axis regulation and facilitate oxytocin release\u2014with the goal of potentially mitigating the acute \u201ccognitive blackout\u201d that patients may experience during diagnostic procedures.\n <\/jats:p>\n <\/jats:sec>\n \n Key findings<\/jats:title>\n By structuring patient interaction, the CLEAR model could help patients regulate their acute stress response, preserving the patient's cognitive clarity and emotional resilience. Furthermore, by defining the radiologist's role within the multidisciplinary Breast Unit, the framework prevents the unproductive \u201cchain of delegation\u201d that frequently results in patient depersonalization.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Re-establishing the radiologist's communicative role is vital for the integrity and efficiency of the Breast Unit. Implementing structured frameworks like the CLEAR protocol ensures diagnostic precision while safeguarding the patient's emotional energy for their subsequent oncological care.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/frhs.2026.1890985","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:34:05Z","timestamp":1787808845000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The CLEAR model: a structured communication protocol for breast radiologists"],"prefix":"10.3389","volume":"6","author":[{"given":"Teresa","family":"Abbattista","sequence":"first","affiliation":[{"name":"Breast Diagnostic Unit, \u201cPrincipe di Piemonte\u201d Hospital, AST Ancona","place":["Senigallia, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aram","family":"Hasan","sequence":"additional","affiliation":[{"name":"United Arab Emirates University Department of Cognitive Sciences","place":["Al Ain, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1016\/j.pec.2009.09.019","article-title":"Women's and residents' experiences of communication in the diagnostic mammography suite","volume":"77","author":"Lown","year":"2009","journal-title":"Patient Educ Couns"},{"key":"B2","doi-asserted-by":"publisher","first-page":"800","DOI":"10.1016\/j.jacr.2007.06.009","article-title":"Breaking bad news: a primer for radiologists in breast imaging","volume":"4","author":"Harvey","year":"2007","journal-title":"J Am Coll Radiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2831","DOI":"10.4081\/jphr.2022.2831","article-title":"Breast cancer and communication: monocentric experience of a self-assessment questionnaire","volume":"11","author":"Longo","year":"2022","journal-title":"J Public Health Res"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1145","DOI":"10.3390\/healthcare12111145","article-title":"Radiologists' communicative role in breast cancer patient management: beyond diagnosis","volume":"12","author":"Mariano","year":"2024","journal-title":"Healthcare (Basel)"},{"key":"B5","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1186\/s40644-020-0292-7","article-title":"\u201cI was seen by a radiologist, but unfortunately I can't remember the name and I still have questions. 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