Breast Imaging: Screening and Diagnosis

Increased knowledge of risks and benefits of current screening modalities as well as new and standard biopsy methods are relevant and timely to the clinical breast radiologist. Radiologists should be able to manipulate digital breast tomosynthesis technology and its implementation in clinical practice. This course reviews new clinical research and outlines novel approaches to current and new techniques and technology. Current standards for breast MRI, and breast biopsy are also discussed, along with breast density and risk assessment models and risk stratification for the patient with dense breasts.

At the conclusion of this activity, participants will be able to describe current and new utilization for digital breast tomosynthesis and its importance in clinical practice; evaluate screening recommendations and controversies along with benefits of screening mammography; utilize Breast MRI for the high risk patient and venues for the diagnostic patient or the average risk patient; explain breast density and its importance in breast cancer risk and risk assessment; and identify the latest applications of imaging technologies.

Module 1

• Breast Density: Significance and Risk—R. Hooley
• Screening Guidelines and Controversy—S. Feig 
• Overdiagnosis—S. Feig
• Missed Breast Cancers—L. Margolies
• Screening Breast Ultrasound—E. Mendelson
• Diagnostic Breast Ultrasound and Elastography—E. Mendelson
• Diagnostic Ultrasound in Adolescents and Males—G. Whitman

Module 2

• Digital Breast Tomosynthesis in an Academic Setting—A. Nees
• Implementation of DBT in a Private Practice—S. Destounis 
• Digital Breast Tomosynthesis Wire Loc and Biopsy—T. Moseley 
• Tomo Pitfalls/Challenges—R. Hooley
• BIRADS 3 Lesions Perils and Pitfalls—L. Margolies
• Biopsy Techniques with US and Stereo–How to get it right—H. Ojeda Fournier
• Panel Discussion and Question and Answer Session

Module 3

• Architectural Distortions and Asymmetries—E. Sonnenblick
• How to Help the Breast Surgeon—H. Ojeda Fournier
• What’s Up in the Axilla?—G. Whitman
• The Pregnant or Breastfeeding Patient: Pitfalls with Standard Imaging—R. Hooley
• Evaluation of the Patient with Spontaneous Discharge—H. Ojeda Fournier
• Case Review with Automated Ultrasound—E. Mendelson
• Limitations of Imaging the Post Treated Breast—L. Moy

Module 4

• Screening MRI—L. Moy
• Abbreviated MRI—C. Comstock
• Contrast Enhanced Mammography—C. Comstock
• Challenging Cases with MRI and CEM—C. Comstock
• Communication with the Patient and Family Members—M. Linver
• The Mammography Audit—M. Linver
• Panel Discussion and Question and Answer Session

Module 5

• Transgender Issues—E. Sonnenblick
• Breast Cancer in Minorities—S. Destounis
• Radioactive Seeds—L. Margolies
• Molecular Breast Imaging: Where does it fit in?—M. Linver
• Risks of Risk Based Screening—S. Feig
• Establishing a High Risk Program—S. Destounis
• High Risk Lesions: Do We Have to Excise?—L. Moy