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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.
Lesson
Pre-Course Activities
1 topic, 2 min.
Lesson
Introduction to Breast MRI
2 topics, 5 min.
Lesson
Indications and Protocol
5 topics, 33 min.
Lesson
MRI BI-RADS
3 topics, 14 min.
Lesson
Enhancing MRI Findings
8 topics, 28 min.
Lesson
Other Findings
4 topics, 20 min.
Lesson
Interpretation and Reporting
4 topics, 25 min.
Lesson
BI-RADS Case Review
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
So our next case is a 61-year-old
0:03
woman for high-risk screening,
0:05
and she's a BRCA2 gene mutation carrier.
0:08
All right, so here's our BRCA2 gene mutation
0:11
carrier patient for high-risk screening.
0:14
On our left side, we have our STIR
0:16
image, and on the right, we have
0:17
a post-contrast subtracted image.
0:20
And just going through from
0:24
the top, of course, this patient had
0:28
comparison studies as well because
0:30
she's been having screening every year.
0:39
And what we noticed was this enhancing focus,
0:46
with kind of borderline focus
0:49
slash small mass because it was
0:51
close to 5 mm in size.
0:54
And when you look at the corresponding
0:55
image on the STIR, it's STIR hypointense,
0:59
there's nothing really there that we're seeing.
1:03
And it was new from previous, and if we go to one
1:09
on one layout and zoom in on this a little bit.
1:14
I think we can see that this is a little
1:18
bit more irregular in terms of its borders.
1:23
It's a little hard to see,
1:24
but it's not exactly a circumscribed
1:28
border as far as this focus goes.
1:30
So since this was new in a BRCA2 gene
1:34
mutation carrier, this was biopsied
1:36
and this turned out to be malignant.
1:38
So this was an invasive lobular carcinoma.
New Focus of Enhancement – Malignant
HIDEInteractive Transcript
0:01
So our next case is a 61-year-old
0:03
woman for high-risk screening,
0:05
and she's a BRCA2 gene mutation carrier.
0:08
All right, so here's our BRCA2 gene mutation
0:11
carrier patient for high-risk screening.
0:14
On our left side, we have our STIR
0:16
image, and on the right, we have
0:17
a post-contrast subtracted image.
0:20
And just going through from
0:24
the top, of course, this patient had
0:28
comparison studies as well because
0:30
she's been having screening every year.
0:39
And what we noticed was this enhancing focus,
0:46
with kind of borderline focus
0:49
slash small mass because it was
0:51
close to 5 mm in size.
0:54
And when you look at the corresponding
0:55
image on the STIR, it's STIR hypointense,
0:59
there's nothing really there that we're seeing.
1:03
And it was new from previous, and if we go to one
1:09
on one layout and zoom in on this a little bit.
1:14
I think we can see that this is a little
1:18
bit more irregular in terms of its borders.
1:23
It's a little hard to see,
1:24
but it's not exactly a circumscribed
1:28
border as far as this focus goes.
1:30
So since this was new in a BRCA2 gene
1:34
mutation carrier, this was biopsied
1:36
and this turned out to be malignant.
1:38
So this was an invasive lobular carcinoma.
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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