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.
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
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
© 2024 Medality. All Rights Reserved.