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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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Get access to free live lectures, every week, from top radiologists.
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Dr. Resnick's MSK Conference
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Musculoskeletal Imaging
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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.
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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
Our next group of patients was
0:02
coded as BI-RADS category six.
0:06
Our first case is a 77-year-old woman
0:09
with a recent diagnosis of right
0:11
breast invasive lobular carcinoma.
0:13
We did an MRI to assess extent of disease.
0:18
So here's the MIP for this patient,
0:20
demonstrating a large irregular enhancing mass
0:23
here in the right anterior lateral breast.
0:28
And the rest of the breast
0:29
tissue is pretty quiet.
0:31
We'll go ahead and look at
0:32
some of the other sequences.
0:35
Pull in our T1, our subtracted
0:38
image, and you can see that there's
0:43
an irregular enhancing mass here.
0:46
There's a circle around the mass with the
0:48
susceptibility artifact from her biopsy
0:50
clip here on the T1-weighted sequence.
0:54
And we went through this whole case.
0:59
She does have a few little enhancing
1:02
foci here and there, but nothing
1:05
suspicious in either breast.
1:09
And surprisingly, even with this three
1:13
centimeter known carcinoma in the
1:15
right breast, there really weren't
1:18
suspicious lymph nodes that
1:20
we were concerned about.
1:21
So let me go ahead and look at
1:23
some of the other sequences.
1:26
So here's T1,
1:29
a pre- and post-contrast source images,
1:33
And just demonstrating that enhancing mass
1:37
again with the artifact from the biopsy
1:40
clip and no other suspicious findings.
1:46
So the patient ended up having a successful
1:51
lumpectomy on the right side and she did
1:56
have sentinel node biopsies and the sentinel
2:00
nodes were negative for metastatic disease.
2:03
So that was a great outcome for her.
Interactive Transcript
0:01
Our next group of patients was
0:02
coded as BI-RADS category six.
0:06
Our first case is a 77-year-old woman
0:09
with a recent diagnosis of right
0:11
breast invasive lobular carcinoma.
0:13
We did an MRI to assess extent of disease.
0:18
So here's the MIP for this patient,
0:20
demonstrating a large irregular enhancing mass
0:23
here in the right anterior lateral breast.
0:28
And the rest of the breast
0:29
tissue is pretty quiet.
0:31
We'll go ahead and look at
0:32
some of the other sequences.
0:35
Pull in our T1, our subtracted
0:38
image, and you can see that there's
0:43
an irregular enhancing mass here.
0:46
There's a circle around the mass with the
0:48
susceptibility artifact from her biopsy
0:50
clip here on the T1-weighted sequence.
0:54
And we went through this whole case.
0:59
She does have a few little enhancing
1:02
foci here and there, but nothing
1:05
suspicious in either breast.
1:09
And surprisingly, even with this three
1:13
centimeter known carcinoma in the
1:15
right breast, there really weren't
1:18
suspicious lymph nodes that
1:20
we were concerned about.
1:21
So let me go ahead and look at
1:23
some of the other sequences.
1:26
So here's T1,
1:29
a pre- and post-contrast source images,
1:33
And just demonstrating that enhancing mass
1:37
again with the artifact from the biopsy
1:40
clip and no other suspicious findings.
1:46
So the patient ended up having a successful
1:51
lumpectomy on the right side and she did
1:56
have sentinel node biopsies and the sentinel
2:00
nodes were negative for metastatic disease.
2:03
So that was a great outcome for her.
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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