Training Collections
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
Training Collections
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
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
Our next patient is a 42-year-old
0:04
woman with a recent diagnosis of
0:06
left invasive ductal carcinoma and DCIS.
0:10
Her MRI was being performed to evaluate extent
0:13
of disease, and this is her MRI, and I'm
0:18
going to zoom in on the left breast because
0:22
that's where clumped and clustered NME is.
0:27
And you can start to see it here in the central
0:30
breast at nipple level. There's clumped
0:34
non-mass enhancement, but there's also a ring of
0:37
enhancement with a central dark area there.
0:39
And as we go through some more of
0:42
this tissue, you can see more rings.
0:45
You know, there were also some masses,
0:47
so some of this was invasive cancer.
0:50
So there's a mixture of clumped and
0:51
clustered ring here coming from the top.
0:59
You can see some of those rings here
1:05
coming down—more rings and they extend
1:09
all the way to the front of the breasts,
1:11
all the way to the anterior breast.
1:13
And there are several areas that are more
1:16
ring-shaped, more irregular-looking
1:18
than the last case that we looked at.
1:21
And in her situation, the more posterior
1:26
aspect had already been biopsied
1:28
and found to be a combination of
1:30
invasive ductal carcinoma and DCIS.
1:33
We did a biopsy of some of this more anterior
1:38
NME to assess extent of disease, and that
1:40
was also more ductal carcinoma in situ.
Clumped and Clustered Ring NME – DCIS
HIDEInteractive Transcript
0:01
Our next patient is a 42-year-old
0:04
woman with a recent diagnosis of
0:06
left invasive ductal carcinoma and DCIS.
0:10
Her MRI was being performed to evaluate extent
0:13
of disease, and this is her MRI, and I'm
0:18
going to zoom in on the left breast because
0:22
that's where clumped and clustered NME is.
0:27
And you can start to see it here in the central
0:30
breast at nipple level. There's clumped
0:34
non-mass enhancement, but there's also a ring of
0:37
enhancement with a central dark area there.
0:39
And as we go through some more of
0:42
this tissue, you can see more rings.
0:45
You know, there were also some masses,
0:47
so some of this was invasive cancer.
0:50
So there's a mixture of clumped and
0:51
clustered ring here coming from the top.
0:59
You can see some of those rings here
1:05
coming down—more rings and they extend
1:09
all the way to the front of the breasts,
1:11
all the way to the anterior breast.
1:13
And there are several areas that are more
1:16
ring-shaped, more irregular-looking
1:18
than the last case that we looked at.
1:21
And in her situation, the more posterior
1:26
aspect had already been biopsied
1:28
and found to be a combination of
1:30
invasive ductal carcinoma and DCIS.
1:33
We did a biopsy of some of this more anterior
1:38
NME to assess extent of disease, and that
1:40
was also more ductal carcinoma in situ.
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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