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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.
Lesson
Pre-Course Activities
1 topic, 1 min.
Lesson
Introduction to Tomosynthesis
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.Lesson
Approach to Interpretation and Lesion Localization
5 topics, 23 min.
Lesson
Normal Imaging Findings
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.Lesson
Asymmetries and Masses
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.Lesson
Gynecomastia
3 topics, 4 min.
Lesson
Fat-containing Lesions
8 topics, 18 min.
Lesson
Architectural Distortion
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.Lesson
Calcifications
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.Lesson
Associated Findings
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.Lesson
Postsurgical Findings
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
This is a 78-year-old female with a history of prior
0:03
lumpectomy or cancer treatment in the right breast.
0:08
She's presenting for a screening, uh, mammogram.
0:13
The left breast is negative, uh, in this case,
0:16
demonstrating just some coarse calcifications.
0:20
On the right, we see the stereotypical
0:23
appearance, postoperative findings.
0:26
We see multiple surgical clips.
0:27
You see a surgical scar marker, uh, in the breast.
0:31
In this case, the periareolar incision was
0:33
done, and then also in the right areola,
0:36
probably related to her lymph node biopsy.
0:39
At the surgical site, we can see this large
0:42
heterogeneous calcification, which has more
0:45
of a rim, uh, sort of configuration, right?
0:47
Some denser at the periphery,
0:49
as compared to the center.
0:51
Um, and this finding is compatible with...
0:56
As we look at, uh, the DBT images, they don't offer
0:59
us a whole lot more of information in this particular
1:02
situation, but we can get a better sense of the
1:05
appearance of that, uh, area of fat necrosis, right?
1:07
It closely, uh, corresponds to probably a...
1:11
previous seroma, uh, cavity potentially.
1:15
Um, and we see those dense, uh, peripherally
1:18
located, uh, calcifications.
1:21
At that site, we see similar findings on the MLO view.
1:26
Again, rim calcifications in this
1:29
large area at the surgical site.
1:31
Taken all that together,
1:32
this can be considered benign and
1:34
just recommend routine screening.
1:36
In some cases, fat necrosis at the surgical site,
1:39
when it's in its earliest phases, it's developing,
1:42
the calcifications, uh, can sort of present as
1:46
small calcifications with differing, uh, sizes
1:51
and shapes, which is the same, uh, way we would
1:53
describe fine, say, amorphous calcifications.
1:56
So it's not uncommon, uh, to have a patient recalled
1:59
from a screening exam, uh, shortly after her
2:03
surgery, uh, in the evaluation of
2:05
calcifications at the surgical site.
2:08
Um, and occasionally those patients do, on subsequent
2:11
biopsy, but in the majority of the cases, uh, the
2:14
calcifications are related to benign fat necrosis.
Post Lumpectomy - Benign Fat Necrosis
HIDEInteractive Transcript
0:01
This is a 78-year-old female with a history of prior
0:03
lumpectomy or cancer treatment in the right breast.
0:08
She's presenting for a screening, uh, mammogram.
0:13
The left breast is negative, uh, in this case,
0:16
demonstrating just some coarse calcifications.
0:20
On the right, we see the stereotypical
0:23
appearance, postoperative findings.
0:26
We see multiple surgical clips.
0:27
You see a surgical scar marker, uh, in the breast.
0:31
In this case, the periareolar incision was
0:33
done, and then also in the right areola,
0:36
probably related to her lymph node biopsy.
0:39
At the surgical site, we can see this large
0:42
heterogeneous calcification, which has more
0:45
of a rim, uh, sort of configuration, right?
0:47
Some denser at the periphery,
0:49
as compared to the center.
0:51
Um, and this finding is compatible with...
0:56
As we look at, uh, the DBT images, they don't offer
0:59
us a whole lot more of information in this particular
1:02
situation, but we can get a better sense of the
1:05
appearance of that, uh, area of fat necrosis, right?
1:07
It closely, uh, corresponds to probably a...
1:11
previous seroma, uh, cavity potentially.
1:15
Um, and we see those dense, uh, peripherally
1:18
located, uh, calcifications.
1:21
At that site, we see similar findings on the MLO view.
1:26
Again, rim calcifications in this
1:29
large area at the surgical site.
1:31
Taken all that together,
1:32
this can be considered benign and
1:34
just recommend routine screening.
1:36
In some cases, fat necrosis at the surgical site,
1:39
when it's in its earliest phases, it's developing,
1:42
the calcifications, uh, can sort of present as
1:46
small calcifications with differing, uh, sizes
1:51
and shapes, which is the same, uh, way we would
1:53
describe fine, say, amorphous calcifications.
1:56
So it's not uncommon, uh, to have a patient recalled
1:59
from a screening exam, uh, shortly after her
2:03
surgery, uh, in the evaluation of
2:05
calcifications at the surgical site.
2:08
Um, and occasionally those patients do, on subsequent
2:11
biopsy, but in the majority of the cases, uh, the
2:14
calcifications are related to benign fat necrosis.
Report
Faculty
Ryan W. Woods, MD, MPH
Assistant Professor of Radiology
University of Wisconsin School of Medicine and Public Health
Tags
Women's Health
Tomosynthesis
Oncologic Imaging
Mammography
Breast
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