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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.
Continuing Medical Education (State CME)
Complete all of your state CME requirements in one convenient place.
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.
Case Crunch: Rapid Case Review (Free)
Register for free live board reviews.
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.
Compliance
NewTrack, fulfill, and report on all your radiologists' credentialing and licensing requirements.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
1 topic, 1 min.
7 topics, 21 min.
Welcome to Advanced Tomosynthesis Mastery Course
1 m.Introduction to Tomosynthesis (DBT) - Why Learn about Tomosynthesis?
3 m.Image Acquisition Technique, Positioning, and Physics
5 m.Screening & Diagnostic Performance of Tomosynthesis
4 m.CAD/AI in Tomosynthesis
2 m.Image Quality and Common Artifacts
8 m.Motion Artifact Case Example on Tomosynthesis
2 m.5 topics, 23 min.
10 topics, 29 min.
Normal Findings - Palpable Lump Focal Fibroglandular Tissue
4 m.Normal Findings - Palpable Lump Unilateral Axillary
4 m.Normal Findings - Palpable Lump Bilateral Axillary
4 m.Normal Findings - Screening Mammogram - Calcifications
3 m.Normal Findings - Screening Mammogram - Dermal Calcifications
3 m.Normal Findings - Screening Mammogram - Deodorant Artifact Example 1
4 m.Normal Findings - Screening Mammogram - Deodorant Artifact Example 2
3 m.Normal Findings - Screening Mammogram - Deodorant Artifact Example 3
2 m.Normal Findings - History of Lumpectomy
4 m.Normal Findings - Diagnostic Mammogram after Right Breast Masses on Screening
4 m.8 topics, 24 min.
Mammographic Asymmetries and Masses - Overview
7 m.Asymmetry - Invasive Ductal Carcinoma
3 m.Focal Asymmetry - Focal Fibroglandular Tissue - Benign
4 m.Developing Asymmetry
4 m.Solitary Mass - Fibroadenoma
2 m.Solitary Mass - Malignancy
3 m.Multiple, Bilateral Masses - Case 1
3 m.Multiple, Bilateral Masses - Case 2
2 m.3 topics, 4 min.
8 topics, 18 min.
5 topics, 17 min.
Architectural Distortion on Tomosynthesis - Imaging & Management - Overview
6 m.Pseudodistortion on Screening Mammogram, Normal on DBT
4 m.Architectural Distortion - Radial Scar / Complex Sclerosing Lesion
4 m.Architectural Distortion - Radiating Lines, Asymmetry / Invasive Ductal Carcinoma (IDC)
3 m.Architectural Distortion - Radiating Lines, Mass / Invasive Lobular Carcinoma (ILC)
3 m.8 topics, 22 min.
Calcifications on Tomosynthesis - Overview
5 m.Pseudocalcifications - Case 1
3 m.Pseudocalcifications - Case 2
3 m.Calcifications - Typically Benign - Milk of Calcium - Case 1
3 m.Calcifications - Typically Benign - Milk of Calcium - Case 2
2 m.Calcifications - Suspicious - Amorphous / Malignancy (BI-RADS 4B)
4 m.Calcifications - Suspicious - Coarse Heterogeneous / Benign
2 m.Calcifications - Suspicious - Segmental Fine Linear Branching / Invasive Ductal Carcinoma (BI-RADS 4C)
4 m.7 topics, 18 min.
Associated Nipple Retraction, Palpable Mass / Invasive Ductal Carcinoma
3 m.Axillary Adenopathy - Unilateral / Chronic Lymphocytic Leukemia (CLL)
3 m.Axillary Adenopathy - Bilateral / History of Chronic Lymphocytic Leukemia (CLL)
2 m.Skin Thickening - Prior Lumpectomy, Post Radiation
2 m.Skin Thickening, Asymmetry - Inflammatory Carcinoma / Invasive Ductal Carcinoma
4 m.Skin Thickening, Calcifications - Inflammatory Carcinoma / Invasive Ductal Carcinoma
3 m.Skin Thickening, Mass - Locally Advanced Breast Carcinoma
3 m.9 topics, 19 min.
Post Breast Reduction - Case 1
4 m.Post Breast Reduction - Case 2
2 m.Post Breast Reduction - Case 3
2 m.Post Lumpectomy - Benign Findings - Case 1
3 m.Post Lumpectomy - Benign Findings - Case 2
2 m.Post Lumpectomy - Recurrence
5 m.Post Lumpectomy - Benign Fat Necrosis
3 m.Silicone Injection
3 m.Concluding Remarks
1 m.0:00
This is a 59-year-old female presenting with a left
0:03
breast palpable abnormality, showing you, uh,
0:07
full-field CC and MLO views of the left breast.
0:09
We see our palpable BB marker, um, in the upper
0:13
inner breast, probably approximately 11 o'clock.
0:18
On these SM views, we can see some scattered
0:21
round calcifications, which look typically benign.
0:24
On the CC view, there's some suggestion of
0:26
asymmetry here in the more medial breast,
0:29
potentially corresponding with a palpable marker.
0:31
And on the MLO view, we see this area
0:34
here with some potential architectural
0:36
distortion here in the upper breast, which
0:37
might correspond to this palpable marker.
0:41
We switch over to the DBT views.
0:42
We'll scroll from the inferiorly
0:44
to superiorly first.
0:47
As we scroll through, she's got heterogeneously
0:50
dense tissue, but if we stop about right
0:52
here, we can see some associated architectural
0:54
distortion and some potential mass here.
0:56
Right now there's lots of radiating lines coming down,
0:59
all directions here, going posteriorly, medially,
1:04
actually laterally here, and this looks like
1:06
it corresponds directly to the palpable finding.
1:08
I'm gonna scroll back to where we
1:09
thought this was the worst area.
1:12
I'll leave that there for a moment.
1:14
If we look at the MLO view,
1:16
we can see, uh, that as we scroll from lateral
1:20
to medial, we get to this point here. We can
1:23
see a large area of architectural distortion
1:25
and a mass, and we see our radiating lines
1:27
here going out in almost all directions.
1:30
Um, and this, uh, is clearly a true, uh, mass
1:34
and architectural distortion finding, which
1:35
warrants further workup with an ultrasound.
1:39
Patient did go on and have an ultrasound.
1:41
We see a large area, uh, at 11 o'clock, five
1:44
centimeters from the nipple, which is heterogeneously,
1:47
hypoechoic, angular, and indistinct margins,
1:50
maybe a little bit of that hyperechoic halo, with
1:53
posterior shadowing and some associated vascularity.
1:56
This corresponds with the finding that
1:58
we saw in the left breast at 11 o'clock on
2:00
the mammogram with that area of distortion,
2:04
and this is highly suspicious for mal—
2:09
Said need clip from that side on the left side.
2:15
Um, we can scroll through and you can see some
2:17
areas that look like there's some potentially
2:19
radiating lines coming out from, uh, this mass.
2:22
And that's the distortion that
2:24
we see on the mammogram as well.
2:25
You can tell on the ultrasound it's
2:26
a lot more difficult to appreciate
2:28
distortion, um, but it's clearly evident.
Interactive Transcript
0:00
This is a 59-year-old female presenting with a left
0:03
breast palpable abnormality, showing you, uh,
0:07
full-field CC and MLO views of the left breast.
0:09
We see our palpable BB marker, um, in the upper
0:13
inner breast, probably approximately 11 o'clock.
0:18
On these SM views, we can see some scattered
0:21
round calcifications, which look typically benign.
0:24
On the CC view, there's some suggestion of
0:26
asymmetry here in the more medial breast,
0:29
potentially corresponding with a palpable marker.
0:31
And on the MLO view, we see this area
0:34
here with some potential architectural
0:36
distortion here in the upper breast, which
0:37
might correspond to this palpable marker.
0:41
We switch over to the DBT views.
0:42
We'll scroll from the inferiorly
0:44
to superiorly first.
0:47
As we scroll through, she's got heterogeneously
0:50
dense tissue, but if we stop about right
0:52
here, we can see some associated architectural
0:54
distortion and some potential mass here.
0:56
Right now there's lots of radiating lines coming down,
0:59
all directions here, going posteriorly, medially,
1:04
actually laterally here, and this looks like
1:06
it corresponds directly to the palpable finding.
1:08
I'm gonna scroll back to where we
1:09
thought this was the worst area.
1:12
I'll leave that there for a moment.
1:14
If we look at the MLO view,
1:16
we can see, uh, that as we scroll from lateral
1:20
to medial, we get to this point here. We can
1:23
see a large area of architectural distortion
1:25
and a mass, and we see our radiating lines
1:27
here going out in almost all directions.
1:30
Um, and this, uh, is clearly a true, uh, mass
1:34
and architectural distortion finding, which
1:35
warrants further workup with an ultrasound.
1:39
Patient did go on and have an ultrasound.
1:41
We see a large area, uh, at 11 o'clock, five
1:44
centimeters from the nipple, which is heterogeneously,
1:47
hypoechoic, angular, and indistinct margins,
1:50
maybe a little bit of that hyperechoic halo, with
1:53
posterior shadowing and some associated vascularity.
1:56
This corresponds with the finding that
1:58
we saw in the left breast at 11 o'clock on
2:00
the mammogram with that area of distortion,
2:04
and this is highly suspicious for mal—
2:09
Said need clip from that side on the left side.
2:15
Um, we can scroll through and you can see some
2:17
areas that look like there's some potentially
2:19
radiating lines coming out from, uh, this mass.
2:22
And that's the distortion that
2:24
we see on the mammogram as well.
2:25
You can tell on the ultrasound it's
2:26
a lot more difficult to appreciate
2:28
distortion, um, but it's clearly evident.
Report
Faculty
Ryan W. Woods, MD, MPH
Assistant Professor of Radiology
University of Wisconsin School of Medicine and Public Health
Tags
Women's Health
Ultrasound
Tomosynthesis
Oncologic Imaging
Mammography
Breast
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