Breast MRI Fellowship Practice Cases

Breast

MBBS

Petra J Lewis

Sheryl G. Jordan

Ryan W. Woods

Gain confidence reading and reporting on Breast MRI Cases with the Medality Fellowship Certificate Program. Practice using real-world, scrollable cases, earn CME, and receive a Fellowship Certificate™ upon completion!

Case Review

Women's Health

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Wk 1, Case 5 -  Review

Practice Cases

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Course Evaluation

Post-Course Activities

Welcome to the Breast MRI Fellowship Practice Cases course! In this course, you&rsquo;ll be presented with a series of worklists, comprised of 25 essential cases you must review to receive your Fellowship Certificate.

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Access Full Fellowship Certificate Program at Anytime <a href="https://mrionline.com/proficiency/breast-mri-fellowship-certificate/" style="text-decoration:none">Here</a>

Breast MRI Practice Cases

HISTORY: 74-year-old woman with recently diagnosed Right breast DCIS presenting for staging.

Summary of prior imaging:

Mammography: New focal asymmetry RUOQ identified on routine screening. Left breast normal.
Ultrasound: 9mm lobulated hypoechoic mass 10:00 Right breast
Breast MRI: N/A

FINDINGS

Quality control issues: ☐None ☐Poor/lack contrast bolus ☐Poor fat suppression
☐Susceptibility ☒Movement ☐Other

Background Parenchymal Enhancement: Minimal
Amount of Fibroglandular Tissue: Scattered fibroglandular tissue

LEFT BREAST

Narrative: There is 2.5 cm of clumped linear non mass enhancement in the upper LEFT breast

Left breast lesion 1
Lesion type: Non-mass enhancement
2.5 cm. Upper outer Quadrant. 12:00 Radian. 5 cm from the nipple

Non mass enhancement: Distribution: Linear, Internal enhancement: Clumped, Kinetics: delayed- Subthreshold

BI-RADS:4: Suspicious abnormality: Tissue diagnosis

Associated findings LEFT: ☒NONE, ☐Nipple retraction, ☐Nipple involvement, ☐Skin retraction, ☐Skin thickening, ☐Skin invasion-direct, ☐Skin invasion-inflammatory, ☐Pectoral muscle invasion, ☐Chest wall invasion, ☐ Architectural distortion

Non-enhancing findings LEFT: ☒NONE, ☐High ductal signal pre contrast T1, ☐Cyst(s), ☐Hematoma/seroma, ☐Post therapy skin/trabecular thickening, ☐Non-enhancing mass, ☐Architectural distortion, ☐Signal void from clips

Fat containing lesions LEFT: ☒NONE, ☐Fat necrosis, ☐Hamartoma, ☐Post-operative seroma/hematoma with fat

Lymph nodes LEFT: ☒Normal axillary, ☐Abnormal axillary, ☐ Abnormal internal mammary

RIGHT BREAST

Narrative: 1.0 irregular mass with a clip at the site of known DCIS. No additional lesions

Right breast lesion 1
Lesion type: Mass
1 cm. Upper outer Quadrant. 10:00 Radian. 4 cm from the nipple

[delete if not needed] Mass/post-surgical change: Shape:Irregular. Margins:Not
circumscribed-irregular . Enhancement: Homogenous. Kinetics: delayed-Plateau

BI-RADS:6: Known biopsy-proven malignancy: Surgical exicision when clinically appropriate

Associated findings RIGHT breast: ☒NONE, ☐Nipple retraction, ☐Nipple involvement, ☐Skin retraction, ☐Skin thickening, ☐Skin invasion-direct, ☐Skin invasion-inflammatory, ☐Pectoral muscle invasion, ☐Chest wall invasion, ☐ Architectural distortion

Non-enhancing findings RIGHT breast: ☒NONE, ☐High ductal signal pre contrast T1, ☐Cyst(s), ☐Hematoma/seroma, ☐Post therapy skin/trabecular thickening,
☐Non-enhancing mass, ☐Architectural distortion, ☐Signal void from clips

Fat containing lesions RIGHT: ☒NONE, ☐Fat necrosis, ☐Hamartoma, ☐Post-operative seroma/hematoma with fat

Lymph nodes RIGHT: ☒Normal axillary, ☐Abnormal axillary, ☐ Abnormal internal mammary

Extramammary findings: None

SUMMARY: Solitary known 1 cm malignancy in the RUOQ with 2.5 cm area 12:00 suspicious for DCIS

LEFT BI-RADS:4: Suspicious abnormality: Tissue diagnosis
RIGHT BI-RADS:6: Known biopsy-proven malignancy – Appropriate action should be taken

RECOMMENDATIONS: MRI guided biopsy of left breast.

Case

74-year-old woman with recently diagnosed Right breast DCIS presenting for staging.Summary of Prior Imaging: Mammography: New focal asymmetry RUOQ identified on routine screening. Left breast normal.Ultrasound: 9mm lobulated hypoechoic mass 10:00 Right breastBreast MRI: NAWhat is the overall BI-RADS assessment for this case?