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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.0:01
In this case, we have a 50-year-old female
0:02
presenting for a baseline screening mammogram.
0:07
If we look at our image quality, um, this
0:10
case looks like it has good image quality.
0:13
Um, and right away we see something, uh,
0:15
in the right, uh, breast here looking like
0:18
it's an approximate subareolar, uh, location.
0:22
Those a little bit closer.
0:24
We'll first pull down the right CC view.
0:29
And right away on this SMV we can see, um,
0:32
it looks like probably a mass, which is
0:34
irregular in shape, uh, spiculated margins or
0:37
potentially associated architectural distortion.
0:39
Um, and looks probably equal density in comparison
0:42
to the rest of the fibroglandular density.
0:45
We scroll through our DBT images, scroll
0:48
through here, and we come to this point here.
0:50
We can see those, uh, fine spiculations, uh,
0:53
and architectural distortion really well.
0:56
So we can see some spiculated margins here.
0:58
These long distortions sort of coming out here, right?
1:01
Giving that kind of pulled in or scar-like appearance.
1:04
Um, certainly an abnormal finding
1:06
that's gonna warrant some further out.
1:08
We pull down the MLO view again, see a
1:11
corresponding finding here in the subareolar
1:13
uh, right breast, maybe an anterior to middle depth.
1:19
And if we scroll through the, uh, DBT slices again,
1:22
uh, and stop here about in the middle, we can see
1:25
these long, uh, areas of architectural distortion,
1:28
so pulling in that tissue and
1:29
giving that appearance in a central
1:32
mass here, probably much smaller in size.
1:35
Of course, it is difficult to
1:36
provide measurements for this.
1:37
Um, I'd say for the most part people probably
1:39
measure the size and don't include this
1:42
area of distortion, although you certainly
1:43
wanna mention it to your technologist.
1:47
Um, the patient, uh, did go on to get, uh, diagnostic
1:50
mammogram and ultrasound, and on diagnostic,
1:55
we can see that same area was seen on our spot
1:57
compression views, uh, not too surprising.
2:00
There didn't actually offer that much
2:02
in addition, getting those particular views.
2:05
And then all of a sudden we see a corresponding
2:07
irregular hypoechoic mass, indistinct
2:10
margin that's in corresponding shadow, a
2:12
subsequently biopsy, and was an invasive lobular carcinoma.
Interactive Transcript
0:01
In this case, we have a 50-year-old female
0:02
presenting for a baseline screening mammogram.
0:07
If we look at our image quality, um, this
0:10
case looks like it has good image quality.
0:13
Um, and right away we see something, uh,
0:15
in the right, uh, breast here looking like
0:18
it's an approximate subareolar, uh, location.
0:22
Those a little bit closer.
0:24
We'll first pull down the right CC view.
0:29
And right away on this SMV we can see, um,
0:32
it looks like probably a mass, which is
0:34
irregular in shape, uh, spiculated margins or
0:37
potentially associated architectural distortion.
0:39
Um, and looks probably equal density in comparison
0:42
to the rest of the fibroglandular density.
0:45
We scroll through our DBT images, scroll
0:48
through here, and we come to this point here.
0:50
We can see those, uh, fine spiculations, uh,
0:53
and architectural distortion really well.
0:56
So we can see some spiculated margins here.
0:58
These long distortions sort of coming out here, right?
1:01
Giving that kind of pulled in or scar-like appearance.
1:04
Um, certainly an abnormal finding
1:06
that's gonna warrant some further out.
1:08
We pull down the MLO view again, see a
1:11
corresponding finding here in the subareolar
1:13
uh, right breast, maybe an anterior to middle depth.
1:19
And if we scroll through the, uh, DBT slices again,
1:22
uh, and stop here about in the middle, we can see
1:25
these long, uh, areas of architectural distortion,
1:28
so pulling in that tissue and
1:29
giving that appearance in a central
1:32
mass here, probably much smaller in size.
1:35
Of course, it is difficult to
1:36
provide measurements for this.
1:37
Um, I'd say for the most part people probably
1:39
measure the size and don't include this
1:42
area of distortion, although you certainly
1:43
wanna mention it to your technologist.
1:47
Um, the patient, uh, did go on to get, uh, diagnostic
1:50
mammogram and ultrasound, and on diagnostic,
1:55
we can see that same area was seen on our spot
1:57
compression views, uh, not too surprising.
2:00
There didn't actually offer that much
2:02
in addition, getting those particular views.
2:05
And then all of a sudden we see a corresponding
2:07
irregular hypoechoic mass, indistinct
2:10
margin that's in corresponding shadow, a
2:12
subsequently biopsy, and was an invasive lobular carcinoma.
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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