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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
Sample Lesson
4 topics, 14 min.
Lesson
Palpable Lumps
5 topics, 16 min.
53-year-old woman with palpable lump in right breast
3 m.25-year-old woman with bilateral breast implants and palpable lump in right breast
2 m.78-year-old woman with palpable lump in right upper outer breast
5 m.54-year-old woman with palpable lump in left breast
5 m.38-year-old woman with palpable lump in right upper breast
5 m.Lesson
Breast Pain
3 topics, 7 min.
Lesson
Nipple Discharge
3 topics, 8 min.
Lesson
Skin Changes/Inflammation
10 topics, 23 min.
Skin Changes and Mastitis Overview
2 m.39-year-old woman with fever and cellulitis of the right breast, recently stopped breastfeeding
3 m.18-year-old woman with painful palpable lump in left breast
2 m.Granulomatous Mastitis Overview
2 m.29-year-old with palpable mass in left breast
2 m.31-year-old woman with palpable lump and skin redness in left breast
5 m.Inflammatory Breast Cancer Overview
2 m.55-year-old woman with skin thickening and redness in right breast
4 m.68-year-old woman with skin thickening and palpable lump in left breast
4 m.43-year-old woman with diffuse left breast pain and palpable lump. Family history of breast cancer
4 m.Lesson
Recall from Screening
29 topics, 1 hr. 7 min.
Asymmetry Overview
6 m.47-year-old woman recalled for asymmetry in left breast
4 m.59-year-old woman recalled for focal asymmetry in left breast
3 m.69-year-old woman recalled for developing asymmetry in right breast
4 m.46-year-old woman recalled for developing asymmetry in right breast
4 m.64-year-old woman recalled for calcifications and developing asymmetry
4 m.51-year-old woman recalled for developing asymmetry in right breast
3 m.79-year-old woman recalled for developing asymmetry in anterior right breast
4 m.Breast Mass Overview
2 m.43-year-old woman recalled for mass in left upper outer breast
3 m.40-year-old woman recalled for 12 mm mass in right breast
2 m.62-year-old woman recalled for mass in right upper outer breast
2 m.80-year-old woman with remote history of right mastectomy, recalled for mass in left breast
3 m.41-year-old woman recalled for mass in right breast
3 m.Architectural Distortion Overview
2 m.69-year-old woman recalled for architectural distortion in left breast
4 m.74-year-old woman recalled for architectural distortion in left breast
3 m.54-year-old woman recalled for distortion in left anterior breast
3 m.62-year-old woman recalled for distortion in left breast
3 m.Calcification Overview
1 m.54-year-old woman recalled for calcifications in left upper outer breast
2 m.57-year-old woman recalled for calcifications in left breast
2 m.51-year-old woman recalled for calcifications in right upper outer breast
2 m.60-year-old woman recalled for calcification in right breast
2 m.53-year-old woman recalled for calcifications in left breast
2 m.Large Axillary Lymph Node Overview
2 m.53-year-old woman recalled for large left axillary lymph node
3 m.80-year-old woman with history of breast cancer treatment recalled for large lymph nodes in left axilla
2 m.49-year-old woman recalled for asymmetry in left breast and large left axillary lymph node
3 m.Lesson
Surveillance After Breast Cancer Treatment
5 topics, 16 min.
Annual Surveillance after Breast Cancer Treatment Overview
4 m.57-year-old woman with history of right breast cancer 10 years ago. Annual follow up
3 m.62-year-old woman with history of left breast cancer 4 years ago. Annual follow up
4 m.61-year-old woman with history of left breast DCIS 10 years ago. Annual follow up
3 m.65-year-old woman with history of left breast cancer 12 years ago. Annual follow up
4 m.Lesson
Follow Up Probably Benign Findings - BI-RADS 3
5 topics, 16 min.
Follow Up Probably Benign Findings- BI-RADS 3 - Overview
8 m.60-year-old woman for 6 month follow up of probably benign calcifications in right breast
3 m.52-year-old woman for 12 month follow up of probably benign 5 mm oval mass in right breast
3 m.16-year-old girl for 6 month follow up of probably benign mass in right breast
3 m.56-year-old woman for follow up of probably benign clustered microcysts in right breast
4 m.Lesson
Follow up Benign Biopsy
3 topics, 5 min.
Lesson
Pregnant and Lactating Women
8 topics, 20 min.
Pregnant and Lactating Women Overview
6 m.26-year-old woman, 20 weeks pregnant, with left breast pain
2 m.32-year-old woman, 21 weeks pregnant, with palpable lump left breast
4 m.33-year-old lactating woman with palpable lump left breast
3 m.32-year-old woman, 1 year postpartum, breastfeeding, with palpable lump left breast
3 m.34-year-old woman, currently lactating, with palpable lump left breast
4 m.28-year-old woman, 1 year postpartum, with palpable lumps right breast
2 m.25-year-old woman, 1 month postpartum, breastfeeding, with palpable lump right breast
2 m.Lesson
Male Patients
5 topics, 12 min.
Symptomatic Male Patient Overview
4 m.65-year-old man with pain and palpable lump behind the left nipple for a few months
2 m.59-year-old man with enlarging and painful left breast over 6 months
3 m.77-year-old man with painful palpable lump in right subareolar breast
3 m.75-year-old man, BRCA2 carrier, with palpable lump in right breast
3 m.0:00
Our next patient is a 37-year-old
0:03
woman with focal left breast pain.
0:06
So for this patient, we have bilateral
0:08
CC views and bilateral MLO views.
0:11
She is 37, so because she's over 30 years
0:16
old, we'll start with a bilateral diagnostic
0:19
mammogram. In this case, CC and MLO views
0:22
of both breasts with tomosynthesis,
0:24
and then we'll ultrasound the area of pain.
0:27
So for her, we've put our little square marker in
0:30
the left upper outer breast in the area of pain,
0:34
and we'll take a closer look at these images.
0:39
So here's her left CC view, and we'll go
0:43
through her tomosynthesis images as well,
0:50
and we can see that marker here
0:52
on her skin in the lateral breast.
0:54
There's some dense tissue underlying that,
0:57
um, area, but nothing really standing out.
1:01
Everything looks good, and we'll go to our MLO
1:07
view, full size, then our tomosynthesis images.
1:17
Scrolling through, the tissue looks normal.
1:22
You can see our square marker on her skin here.
1:28
I think as we were going through, we, we saw
1:31
this asymmetry here in the central breast.
1:34
Sometimes you find some incidental finding.
1:37
So we went ahead and looked at that with a
1:40
spot compression view.
1:43
So here's our spot in that area.
1:47
And the tissue effaces
1:49
partially with spot compression.
1:53
We did a lateral view as
1:55
well, which looks very normal.
2:00
And we did a lateral view with tomosynthesis.
2:08
And I think, you know, in these patients who
2:10
are between 30 and 40, if they're at normal
2:14
risk, one of the challenges is that you have
2:18
to be comfortable that you're not going to
2:20
be seeing these patients again until age 40.
2:23
So, we usually try to work up,
2:25
um, other areas if we see them.
2:28
So, really nothing suspicious,
2:30
we've got our square marker again there.
2:32
So, our next step for her
2:34
would be to do ultrasound.sss
2:35
So, this is her ultrasound in the
2:38
area of pain, which is one o'clock,
2:40
four centimeters from the nipple.
2:42
So, we can see her skin,
2:43
her subcutaneous fat, um, dense tissue here.
2:48
And really tissue looks normal
2:51
throughout that lateral breast where
2:53
she stated that she had the pain.
2:55
So it was from one, one o'clock to four o'clock
2:58
position and all of that tissue looks normal.
3:01
So for her, we decided this was normal and
3:06
I think we gave her a BI-RADS category two
3:08
because of the breast asymmetries, um,
3:12
and then referred her back to her provider and
3:15
recommended, uh, screening mammography at age 40.
37-year-old woman with focal left breast pain
HIDEInteractive Transcript
0:00
Our next patient is a 37-year-old
0:03
woman with focal left breast pain.
0:06
So for this patient, we have bilateral
0:08
CC views and bilateral MLO views.
0:11
She is 37, so because she's over 30 years
0:16
old, we'll start with a bilateral diagnostic
0:19
mammogram. In this case, CC and MLO views
0:22
of both breasts with tomosynthesis,
0:24
and then we'll ultrasound the area of pain.
0:27
So for her, we've put our little square marker in
0:30
the left upper outer breast in the area of pain,
0:34
and we'll take a closer look at these images.
0:39
So here's her left CC view, and we'll go
0:43
through her tomosynthesis images as well,
0:50
and we can see that marker here
0:52
on her skin in the lateral breast.
0:54
There's some dense tissue underlying that,
0:57
um, area, but nothing really standing out.
1:01
Everything looks good, and we'll go to our MLO
1:07
view, full size, then our tomosynthesis images.
1:17
Scrolling through, the tissue looks normal.
1:22
You can see our square marker on her skin here.
1:28
I think as we were going through, we, we saw
1:31
this asymmetry here in the central breast.
1:34
Sometimes you find some incidental finding.
1:37
So we went ahead and looked at that with a
1:40
spot compression view.
1:43
So here's our spot in that area.
1:47
And the tissue effaces
1:49
partially with spot compression.
1:53
We did a lateral view as
1:55
well, which looks very normal.
2:00
And we did a lateral view with tomosynthesis.
2:08
And I think, you know, in these patients who
2:10
are between 30 and 40, if they're at normal
2:14
risk, one of the challenges is that you have
2:18
to be comfortable that you're not going to
2:20
be seeing these patients again until age 40.
2:23
So, we usually try to work up,
2:25
um, other areas if we see them.
2:28
So, really nothing suspicious,
2:30
we've got our square marker again there.
2:32
So, our next step for her
2:34
would be to do ultrasound.sss
2:35
So, this is her ultrasound in the
2:38
area of pain, which is one o'clock,
2:40
four centimeters from the nipple.
2:42
So, we can see her skin,
2:43
her subcutaneous fat, um, dense tissue here.
2:48
And really tissue looks normal
2:51
throughout that lateral breast where
2:53
she stated that she had the pain.
2:55
So it was from one, one o'clock to four o'clock
2:58
position and all of that tissue looks normal.
3:01
So for her, we decided this was normal and
3:06
I think we gave her a BI-RADS category two
3:08
because of the breast asymmetries, um,
3:12
and then referred her back to her provider and
3:15
recommended, uh, screening mammography at age 40.
Report
Faculty
Lisa Ann Mullen, MD
Assistant Professor; Breast Imaging Fellowship Director
Johns Hopkins Medicine
Tags
Women's Health
Ultrasound
Tomosynthesis
Mammography
Idiopathic
Breast
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