Training Collections
Library Memberships
Black Friday Save 30%On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Black Friday Save 30%Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Black Friday Save 40%Unlock access to our full Course Library and all self-paced Fellowships.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Dr. Resnick's MSK Conference
BLACK FRIDAY SAVE 30%Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
Training Collections
Library Memberships
Black Friday Save 30%On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Black Friday Save 30%Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Black Friday Save 40%Unlock access to our full Course Library and all self-paced Fellowships.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Dr. Resnick's MSK Conference
BLACK FRIDAY SAVE 30%Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
1 topic, 2 min.
2 topics, 5 min.
5 topics, 33 min.
3 topics, 14 min.
8 topics, 28 min.
4 topics, 20 min.
4 topics, 25 min.
22 topics, 1 hr. 17 min.
BI-RADS Assessment Categories – Overview
11 m.BI-RADS 1
5 m.BI-RADS 2 – Left Lumpectomy
4 m.BI-RADS 2 – Right Lumpectomy, Right Non-Enhancing Mass
2 m.BI-RADS 2 – Left Post Excisional Biopsy Change
3 m.BI-RADS 2 – Marked BPE, Stable
3 m.BI-RADS 2 – Bilateral Stable Findings
4 m.New focus of enhancement on a high risk patient (BI-RADS 4)
3 m.BI-RADS 3 – Changing Pattern of Background
2 m.BI-RADS 4 – Linear NME, Left Breast
4 m.BI-RADS 4 – Right Extensive DCIS, Left Dominant Focus
4 m.BI-RADS 4 – New Diagnosis Left Cancer, Focal NME left
3 m.BI-RADS 4 – New Diagnosis Right Breast Cancer, Nodes on Right
5 m.BI-RADS 4 – Left Axillary Node Metastasis, Evaluate for Breast Cancer
3 m.BI-RADS 5 – Suspicious Mass in Left Breast, Not Biopsied Yet
5 m.BI-RADS 5 – Left Breast Cancer, MRI Shows Right Cancer
5 m.BI-RADS 5 – New Diagnosis Right Cancer, Suspicious Masses in Right Breast
3 m.BI-RADS 5 – Right Inflammatory Cancer, Bilateral Nodes
4 m.BI-RADS 6 – Right Breast Cancer, No Other Findings
3 m.BI-RADS 6 – Left Breast Cancer, No Other Findings
2 m.BI-RADS 6 – Left Breast Cancer, Index Mass
4 m.BI-RADS 6 – Pre and Post Neoadjuvant Chemotherapy (NAC) for Left Breast Cancer
5 m.0:01
Our next case is a 34-year-old
0:03
woman for high-risk screening.
0:05
This was her baseline MRI, and she had
0:08
a history of right breast biopsy and a
0:10
strong family history of breast cancer.
0:13
So to start with, this is the patient's
0:15
MIP, and this is a case we saw earlier
0:18
in this Mastery Series, but I think
0:20
it's a good example of, uh, BI-RADS 3.
0:24
So she has asymmetric background
0:26
parenchymal enhancement, lots of
0:28
enhancement here on the right side,
0:31
less on the left, but the enhancement she
0:34
has on the left is a little bit more focal.
0:36
And
0:39
we're going to pull in her T1 and
0:44
her first post-contrast images.
0:48
So she has heterogeneous
0:52
or extremely fibroglandular tissue.
0:55
She's had a biopsy on the right, so you see the
0:58
susceptibility artifact from her biopsy clip.
1:00
And then you can see all this enhancement
1:03
here, mostly on the right side.
1:10
And in her case, we felt that since this
1:12
was a baseline and the enhancement looked
1:15
like it might be, um, mostly at the edges of
1:19
her tissue, kind of a very typical pattern
1:22
of background parenchymal enhancement,
1:26
we elected to do a six-month follow-up.
1:28
And mostly that was because this
1:29
wasn't symmetric bilaterally.
1:32
And she did have some more focal
1:35
enhancement here on the left.
1:38
So we considered this to be BI-RADS 3, and
1:41
we saw her in six months, at which time the
1:45
enhancement had almost completely resolved.
Interactive Transcript
0:01
Our next case is a 34-year-old
0:03
woman for high-risk screening.
0:05
This was her baseline MRI, and she had
0:08
a history of right breast biopsy and a
0:10
strong family history of breast cancer.
0:13
So to start with, this is the patient's
0:15
MIP, and this is a case we saw earlier
0:18
in this Mastery Series, but I think
0:20
it's a good example of, uh, BI-RADS 3.
0:24
So she has asymmetric background
0:26
parenchymal enhancement, lots of
0:28
enhancement here on the right side,
0:31
less on the left, but the enhancement she
0:34
has on the left is a little bit more focal.
0:36
And
0:39
we're going to pull in her T1 and
0:44
her first post-contrast images.
0:48
So she has heterogeneous
0:52
or extremely fibroglandular tissue.
0:55
She's had a biopsy on the right, so you see the
0:58
susceptibility artifact from her biopsy clip.
1:00
And then you can see all this enhancement
1:03
here, mostly on the right side.
1:10
And in her case, we felt that since this
1:12
was a baseline and the enhancement looked
1:15
like it might be, um, mostly at the edges of
1:19
her tissue, kind of a very typical pattern
1:22
of background parenchymal enhancement,
1:26
we elected to do a six-month follow-up.
1:28
And mostly that was because this
1:29
wasn't symmetric bilaterally.
1:32
And she did have some more focal
1:35
enhancement here on the left.
1:38
So we considered this to be BI-RADS 3, and
1:41
we saw her in six months, at which time the
1:45
enhancement had almost completely resolved.
Report
Description
Faculty
Lisa Ann Mullen, MD
Assistant Professor; Breast Imaging Fellowship Director
Johns Hopkins Medicine
Tags
Women's Health
MRI
Breast
© 2024 Medality. All Rights Reserved.