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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
So our first case is a 50-year-old
0:02
woman with clear left nipple discharge.
0:06
So for this patient, we have CC views
0:09
at the top of our screen and MLO
0:11
views at the bottom of the screen.
0:13
And her discharge was on the left and was clear.
0:17
And we can see this duct or, you know, kind of
0:21
branching duct behind the nipple on the CC view.
0:25
And then you see that sort of
0:26
single duct on the MLO view.
0:29
She had had a prior biopsy of something near
0:33
this, but it wasn't exactly in the same place.
0:35
You can see that ribbon-shaped biopsy clip here.
0:38
So we'll look at these
0:39
images a little more closely.
0:41
17 00:00:42,405 --> 00:00:46,185 This is the left, uh, CC view, and we'll go
0:46
through our tomosynthesis images as well.
0:50
We can see that large duct very nicely
0:53
shown with the tomosynthesis images
0:55
with several branches coming off of it.
0:59
And then we can see that clip,
1:01
which is, uh, separate from the duct.
1:04
So that's the CC.
1:08
Here's our MLO view and our tomosynthesis images.
1:17
And you can see as we're scrolling through,
1:18
we can see that clip, and then we have this,
1:21
you know, large duct centrally, and then branching,
1:27
and really nothing else going on in that breast.
1:31
In a lot of cases, this may be the, um,
1:33
our chance to screen the opposite breast,
1:35
so we always want to make sure that we're
1:38
taking a good look at the other breast.
1:41
So, this is the right CC view and
1:45
right CC tomosynthesis images showing
1:49
some benign calcifications and a
1:54
little intramammary lymph node there
1:56
laterally, otherwise nothing suspicious.
2:02
Look at the right MLO view
2:11
and the MLO tomosynthesis images
2:19
showing some normal-looking lymph nodes.
2:23
Normal-looking intramammary lymph
2:24
node, but nothing suspicious there.
2:27
So our next step for this
2:29
patient will be, um, ultrasound.
2:33
So we did the ultrasound, and basically
2:37
we see this big duct with, um,
2:40
a mass inside it with some blood flow.
2:47
Actually, some nice images, uh, from the
2:49
day she came in for biopsy showing that
2:53
large duct, and, uh, mass within the, uh,
2:57
duct, and some blood flow within the mass.
3:02
So, um, in this case, we went ahead
3:06
and recommended ultrasound-guided
3:07
biopsy since we could see it that way.
3:10
And, um, this turned out to be a benign papilloma.
50-year-old woman with clear left nipple discharge (benign papilloma)
HIDEInteractive Transcript
0:00
So our first case is a 50-year-old
0:02
woman with clear left nipple discharge.
0:06
So for this patient, we have CC views
0:09
at the top of our screen and MLO
0:11
views at the bottom of the screen.
0:13
And her discharge was on the left and was clear.
0:17
And we can see this duct or, you know, kind of
0:21
branching duct behind the nipple on the CC view.
0:25
And then you see that sort of
0:26
single duct on the MLO view.
0:29
She had had a prior biopsy of something near
0:33
this, but it wasn't exactly in the same place.
0:35
You can see that ribbon-shaped biopsy clip here.
0:38
So we'll look at these
0:39
images a little more closely.
0:41
17 00:00:42,405 --> 00:00:46,185 This is the left, uh, CC view, and we'll go
0:46
through our tomosynthesis images as well.
0:50
We can see that large duct very nicely
0:53
shown with the tomosynthesis images
0:55
with several branches coming off of it.
0:59
And then we can see that clip,
1:01
which is, uh, separate from the duct.
1:04
So that's the CC.
1:08
Here's our MLO view and our tomosynthesis images.
1:17
And you can see as we're scrolling through,
1:18
we can see that clip, and then we have this,
1:21
you know, large duct centrally, and then branching,
1:27
and really nothing else going on in that breast.
1:31
In a lot of cases, this may be the, um,
1:33
our chance to screen the opposite breast,
1:35
so we always want to make sure that we're
1:38
taking a good look at the other breast.
1:41
So, this is the right CC view and
1:45
right CC tomosynthesis images showing
1:49
some benign calcifications and a
1:54
little intramammary lymph node there
1:56
laterally, otherwise nothing suspicious.
2:02
Look at the right MLO view
2:11
and the MLO tomosynthesis images
2:19
showing some normal-looking lymph nodes.
2:23
Normal-looking intramammary lymph
2:24
node, but nothing suspicious there.
2:27
So our next step for this
2:29
patient will be, um, ultrasound.
2:33
So we did the ultrasound, and basically
2:37
we see this big duct with, um,
2:40
a mass inside it with some blood flow.
2:47
Actually, some nice images, uh, from the
2:49
day she came in for biopsy showing that
2:53
large duct, and, uh, mass within the, uh,
2:57
duct, and some blood flow within the mass.
3:02
So, um, in this case, we went ahead
3:06
and recommended ultrasound-guided
3:07
biopsy since we could see it that way.
3:10
And, um, this turned out to be a benign papilloma.
Report
Faculty
Lisa Ann Mullen, MD
Assistant Professor; Breast Imaging Fellowship Director
Johns Hopkins Medicine
Tags
Women's Health
Ultrasound
Tomosynthesis
Non-infectious Inflammatory
Mammography
Breast
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