MR of Well-Circumscribed Breast Carcinomas

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Breast Sonography: 1.50
Patient Care: 1.00
Patient Interactions and Management: 1.00
Procedures: 0.50
Pathology: 0.50

Mammography: 1.50
Procedures: 1.50
Anatomy, Physiology, and Pathology: 0.50
Mammographic Positioning, Special Needs, and Imaging Procedures: 1.00

Magnetic Resonance Imaging: 2.00
Patient Care: 0.25
Patient Interactions and Management: 0.25
Procedures: 1.75
Body: 1.75

Nuclear Medicine Technology: 1.00
Patient Care: 0.50
Patient Interactions and Management: 0.50
Procedures: 0.50
Endocrine and Oncology Procedures: 0.50

Registered Radiologist Assistant: 1.75
Procedures: 1.75
Thoracic Section: 1.75

Sonography: 1.50
Patient Care: 0.50
Patient Interactions and Management: 0.50
Procedures: 1.00
Superficial Structures and Other Sonographic Procedures: 1.00

Radiation Therapy: 1.50
Patient Care: 0.75
Patient and Medical Record Management: 0.75
Procedures: 0.75
Treatment Sites and Tumors: 0.75

Outline

1. Introduction
2. Intracystic Papillary Carcinoma
3. Invasive Papillary Carcinoma
4. Mucinous Carcinoma
5. Medullary Carcinoma
6. Metaplastic Carcinoma
7. Malignant Phyllodes Tumor
8. Conclusions

Objectives

Upon completion of this course, students will:

1. identify the conventional breast imaging modalities
2. understand how MRI enables differentiation between benign and malignant lesions
3. learn about kinetic assessment
4. identify type II kinetic curves
5. recognize characteristics of lesion margins associated with malignancy
6. learn the role of MRI in breast lesion assessment
7. know requirements of DCE
8. realize the importance of breast MR quality control measures
9. describe characteristics of intracystic papillary carcinoma
10. recognize the composition of intracystic papillary carcinoma
11. know the core sequences currently used in breast MR imaging
12. identify the type of kinetic curve from intracystic papillary carcinoma
13. know the prevalence of bloody nipple discharge associated with invasive papillary carcinoma
14. identify MR appearance of intracystic papillary carcinoma
15. describe the appearance of invasive papillary carcinoma
16. know the structure of the fibrous wall surrounding invasive papillary carcinoma
17. recognize histological properties of mucinous carcinoma
18. understand characteristics of mucinous carcinoma that can be unfavorable
19. recognize the type of mucinous carcinoma with a more favorable outcome
20. know how age affects outcomes of mucinous carconoma
21. realize that a type I persistent curve doesn’t mean there’s no concern of malignancy
22. know the MR appearance of mucinous carcinoma
23. understand the prevalence of medullary carcinoma, both overall and in the younger population
24. identify image manifestations of medullary carcinoma
25. identify a common artifact seen on MR breast images
26. reinforce understanding of curve contour on kinetic data sets
27. learn the purpose of computer aided detection (CAD) software
28. know CAD applies different colors based on delayed phases of the kinetic curve
29. recognize the purpose of subtraction methods incorporated with DCE MRI
30. understand the meaning of metaplasia
31. learn characteristics of metaplastic carcinoma
32. identify properties that affect the metaplastic carcinoma complexities seen on US
33. identify properties that affect how metaplastic carcinoma appears on MRI
34. know how phyllodes tumors are histotypically divided
35. identify additional properties used for phyllodes assessment
36. learn why phyllodes requires excision
37. recognize that malignant phyllodes tumors mimic a benign lesion
38. understand enhancement properties from certain sensitive areas of the phyllodes tumor
39. know what lesion does not demonstrate contrast enhancement on MRI
40. understand how MRI helps to characterize well-circumscribed, benign-looking breast lesions