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Training Collections
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Black Friday Save 30%Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
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Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
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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
And our next case is a 48-year-old woman with a
0:05
recent diagnosis of left breast cancer, and MRI
0:08
was performed to evaluate extent of disease.
0:12
We'll go to her MIP and just show you this.
0:15
So the patient has a large enhancing mass in the
0:19
left breast, and this was a known breast cancer.
0:23
And she also has some moderate
0:25
background parenchymal enhancement.
0:27
So we're going to take a look at some other
0:30
series and investigate this a little bit more.
0:35
So again, I'm pulling her
0:37
T1-weighted and first subtracted
0:41
series.
0:42
You can see that she has heterogeneous
0:45
fibroglandular tissue and
0:48
moderate background enhancement.
0:50
There's a lot of little,
0:52
little foci, little spots that enhance
0:56
and background enhancement.
0:59
As we go through the left breast,
1:00
you can see this irregular mass.
1:03
There is a susceptibility artifact from
1:05
a biopsy clip centrally, and that's the
1:09
area where her biopsy clip is located,
1:12
and that was her known breast cancer.
1:16
And as we scroll through, there's a lot of
1:18
background enhancement, but there's one area
1:21
that stood out as being a little bit different
1:26
to us, and it was right here, kind of in the
1:29
same plane or at the same level as her mass.
1:33
She had a little area of non-mass
1:35
enhancement, focal non-mass enhancement,
1:38
and we elected to biopsy this
1:44
after, you know, further evaluation.
1:46
But basically we looked at,
1:48
you know, all of her exam and
1:55
nothing else really stood out like this did.
1:58
So the biopsy was performed and that was
2:03
benign, benign breast tissue and something
2:07
called pseudoangiomatous stromal hyperplasia,
2:11
which is abbreviated as PASH, P A S H.
2:14
And that's actually a fairly common
2:16
result when we do MRI-guided biopsies
2:19
of areas of non-mass enhancement.
2:22
So that was our finding here.
2:26
So because this was benign, the patient
2:27
was able to go on to a lumpectomy,
2:31
just involving the known breast cancer.
Interactive Transcript
0:01
And our next case is a 48-year-old woman with a
0:05
recent diagnosis of left breast cancer, and MRI
0:08
was performed to evaluate extent of disease.
0:12
We'll go to her MIP and just show you this.
0:15
So the patient has a large enhancing mass in the
0:19
left breast, and this was a known breast cancer.
0:23
And she also has some moderate
0:25
background parenchymal enhancement.
0:27
So we're going to take a look at some other
0:30
series and investigate this a little bit more.
0:35
So again, I'm pulling her
0:37
T1-weighted and first subtracted
0:41
series.
0:42
You can see that she has heterogeneous
0:45
fibroglandular tissue and
0:48
moderate background enhancement.
0:50
There's a lot of little,
0:52
little foci, little spots that enhance
0:56
and background enhancement.
0:59
As we go through the left breast,
1:00
you can see this irregular mass.
1:03
There is a susceptibility artifact from
1:05
a biopsy clip centrally, and that's the
1:09
area where her biopsy clip is located,
1:12
and that was her known breast cancer.
1:16
And as we scroll through, there's a lot of
1:18
background enhancement, but there's one area
1:21
that stood out as being a little bit different
1:26
to us, and it was right here, kind of in the
1:29
same plane or at the same level as her mass.
1:33
She had a little area of non-mass
1:35
enhancement, focal non-mass enhancement,
1:38
and we elected to biopsy this
1:44
after, you know, further evaluation.
1:46
But basically we looked at,
1:48
you know, all of her exam and
1:55
nothing else really stood out like this did.
1:58
So the biopsy was performed and that was
2:03
benign, benign breast tissue and something
2:07
called pseudoangiomatous stromal hyperplasia,
2:11
which is abbreviated as PASH, P A S H.
2:14
And that's actually a fairly common
2:16
result when we do MRI-guided biopsies
2:19
of areas of non-mass enhancement.
2:22
So that was our finding here.
2:26
So because this was benign, the patient
2:27
was able to go on to a lumpectomy,
2:31
just involving the known breast cancer.
Report
Description
Faculty
Lisa Ann Mullen, MD
Assistant Professor; Breast Imaging Fellowship Director
Johns Hopkins Medicine
Tags
Women's Health
Neoplastic
MRI
Breast
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