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Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
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
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 35-year-old woman
0:03
with right bloody nipple discharge.
0:06
So, this patient elected to have a 2D mammogram.
0:10
We have bilateral CC views at the
0:13
top of the screen, bilateral MLO
0:15
views at the bottom of the screen.
0:17
Because this patient is over 35, we started
0:20
with a mammogram, and we can see that
0:23
there are some calcifications here in
0:26
the right lateral breast and right upper
0:29
breast, nothing obvious on the other sides.
0:33
We're just going to look a
0:34
little more closely at this.
0:37
So here's the right breast.
0:38
There's some segmental calcifications
0:41
here going toward the nipple.
0:45
So here's the magnification
0:46
view in the CC projection.
0:48
And you can see all of these calcifications,
0:50
kind of some coarse heterogeneous
0:52
calcifications, some more amorphous
0:54
calcifications in a segmental distribution,
0:57
kind of going all the way up to the nipple.
1:00
And then on the MLO view,
1:03
you can see them again here.
1:05
And we did a lateral magnification
1:08
view, which is right here.
1:11
You can see those calcifications
1:13
pretty tightly grouped there.
1:15
And then a couple of calcifications
1:17
extending into the nipple.
1:19
Um, so the calcifications alone are suspicious.
1:22
And we went ahead and did an
1:23
ultrasound as well for this patient.
1:26
So here's the ultrasound that was performed.
1:28
Here's her nipple, and right away we started
1:33
seeing a duct with some echogenic flecks within
1:40
it, which are the calcifications inside the duct
1:45
tissues, very heterogeneous, but there were a lot
1:47
of these calcifications were visible, no obvious
1:53
mass, just the calcifications and the tissue was
1:58
a little bit hypoechoic throughout that area.
2:03
We also looked at, um, lymph nodes,
2:06
which we thought were normal.
2:10
But the interesting part of this was just.
2:12
the ability to actually follow that duct
2:15
and see the calcifications within it.
2:18
Um, so for this patient, we thought we could
2:21
see these calcifications best on the mammogram.
2:24
So we recommended a stereotactic or a mammogram
2:28
guided biopsy of those calcifications.
2:31
And, um, this was ductal carcinoma in situ.
2:35
And the process was extensive enough
2:37
that the patient ended up opting
2:40
to have a mastectomy for treatment.
35-year-old woman with right bloody nipple discharge
HIDEInteractive Transcript
0:00
Our next patient is a 35-year-old woman
0:03
with right bloody nipple discharge.
0:06
So, this patient elected to have a 2D mammogram.
0:10
We have bilateral CC views at the
0:13
top of the screen, bilateral MLO
0:15
views at the bottom of the screen.
0:17
Because this patient is over 35, we started
0:20
with a mammogram, and we can see that
0:23
there are some calcifications here in
0:26
the right lateral breast and right upper
0:29
breast, nothing obvious on the other sides.
0:33
We're just going to look a
0:34
little more closely at this.
0:37
So here's the right breast.
0:38
There's some segmental calcifications
0:41
here going toward the nipple.
0:45
So here's the magnification
0:46
view in the CC projection.
0:48
And you can see all of these calcifications,
0:50
kind of some coarse heterogeneous
0:52
calcifications, some more amorphous
0:54
calcifications in a segmental distribution,
0:57
kind of going all the way up to the nipple.
1:00
And then on the MLO view,
1:03
you can see them again here.
1:05
And we did a lateral magnification
1:08
view, which is right here.
1:11
You can see those calcifications
1:13
pretty tightly grouped there.
1:15
And then a couple of calcifications
1:17
extending into the nipple.
1:19
Um, so the calcifications alone are suspicious.
1:22
And we went ahead and did an
1:23
ultrasound as well for this patient.
1:26
So here's the ultrasound that was performed.
1:28
Here's her nipple, and right away we started
1:33
seeing a duct with some echogenic flecks within
1:40
it, which are the calcifications inside the duct
1:45
tissues, very heterogeneous, but there were a lot
1:47
of these calcifications were visible, no obvious
1:53
mass, just the calcifications and the tissue was
1:58
a little bit hypoechoic throughout that area.
2:03
We also looked at, um, lymph nodes,
2:06
which we thought were normal.
2:10
But the interesting part of this was just.
2:12
the ability to actually follow that duct
2:15
and see the calcifications within it.
2:18
Um, so for this patient, we thought we could
2:21
see these calcifications best on the mammogram.
2:24
So we recommended a stereotactic or a mammogram
2:28
guided biopsy of those calcifications.
2:31
And, um, this was ductal carcinoma in situ.
2:35
And the process was extensive enough
2:37
that the patient ended up opting
2:40
to have a mastectomy for treatment.
Report
Faculty
Lisa Ann Mullen, MD
Assistant Professor; Breast Imaging Fellowship Director
Johns Hopkins Medicine
Tags
Women's Health
Ultrasound
Neoplastic
Mammography
Breast
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