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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.
1 topic, 2 min.
2 topics, 5 min.
5 topics, 33 min.
3 topics, 14 min.
8 topics, 28 min.
4 topics, 20 min.
4 topics, 25 min.
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 group of patients was
0:02
coded as BI-RADS category six.
0:06
Our first case is a 77-year-old woman
0:09
with a recent diagnosis of right
0:11
breast invasive lobular carcinoma.
0:13
We did an MRI to assess extent of disease.
0:18
So here's the MIP for this patient,
0:20
demonstrating a large irregular enhancing mass
0:23
here in the right anterior lateral breast.
0:28
And the rest of the breast
0:29
tissue is pretty quiet.
0:31
We'll go ahead and look at
0:32
some of the other sequences.
0:35
Pull in our T1, our subtracted
0:38
image, and you can see that there's
0:43
an irregular enhancing mass here.
0:46
There's a circle around the mass with the
0:48
susceptibility artifact from her biopsy
0:50
clip here on the T1-weighted sequence.
0:54
And we went through this whole case.
0:59
She does have a few little enhancing
1:02
foci here and there, but nothing
1:05
suspicious in either breast.
1:09
And surprisingly, even with this three
1:13
centimeter known carcinoma in the
1:15
right breast, there really weren't
1:18
suspicious lymph nodes that
1:20
we were concerned about.
1:21
So let me go ahead and look at
1:23
some of the other sequences.
1:26
So here's T1,
1:29
a pre- and post-contrast source images,
1:33
And just demonstrating that enhancing mass
1:37
again with the artifact from the biopsy
1:40
clip and no other suspicious findings.
1:46
So the patient ended up having a successful
1:51
lumpectomy on the right side and she did
1:56
have sentinel node biopsies and the sentinel
2:00
nodes were negative for metastatic disease.
2:03
So that was a great outcome for her.
Interactive Transcript
0:01
Our next group of patients was
0:02
coded as BI-RADS category six.
0:06
Our first case is a 77-year-old woman
0:09
with a recent diagnosis of right
0:11
breast invasive lobular carcinoma.
0:13
We did an MRI to assess extent of disease.
0:18
So here's the MIP for this patient,
0:20
demonstrating a large irregular enhancing mass
0:23
here in the right anterior lateral breast.
0:28
And the rest of the breast
0:29
tissue is pretty quiet.
0:31
We'll go ahead and look at
0:32
some of the other sequences.
0:35
Pull in our T1, our subtracted
0:38
image, and you can see that there's
0:43
an irregular enhancing mass here.
0:46
There's a circle around the mass with the
0:48
susceptibility artifact from her biopsy
0:50
clip here on the T1-weighted sequence.
0:54
And we went through this whole case.
0:59
She does have a few little enhancing
1:02
foci here and there, but nothing
1:05
suspicious in either breast.
1:09
And surprisingly, even with this three
1:13
centimeter known carcinoma in the
1:15
right breast, there really weren't
1:18
suspicious lymph nodes that
1:20
we were concerned about.
1:21
So let me go ahead and look at
1:23
some of the other sequences.
1:26
So here's T1,
1:29
a pre- and post-contrast source images,
1:33
And just demonstrating that enhancing mass
1:37
again with the artifact from the biopsy
1:40
clip and no other suspicious findings.
1:46
So the patient ended up having a successful
1:51
lumpectomy on the right side and she did
1:56
have sentinel node biopsies and the sentinel
2:00
nodes were negative for metastatic disease.
2:03
So that was a great outcome for her.
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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