Entry level lectures

"Introductory lecture” classifies breast malignancy according to their site of origin.  

Understand and account for every detail on the mammogram: Large format subgross (3D) histopathologic-imaging correlation.

Capabilities and limitations of finding early breast cancer depending on the mammographic parenchymal patterns. Introduction to the solution of reading mammograms of women with dense breasts.

This is the first lecture in our new series of interactive lectures that teaches the basis for efficient interpretation of the normal mammogram.

This long lecture contains 1) the imaging biomarkers of breast cancers originating in the major ducts and in the mesenchymal stem cells 2) Description of the regions on the mammogram where most of the breast cancers are found 3) The technique of how to view a mammogram 4) Interactive cases to enhance the teaching points and challenge the audience

Continuation of interactive case demonstrations with audience participation, using a polling system, providing immediate feedback about audience performance.

A short summary of the basic issues when looking for pathologic lesions on the mammogram is followed by interactive case demonstrations of a mixture of normal and very challenging cancer cases localized on the "Milky way", i.e. the region where 61% of all breast cancers are localized.

This lecture teaches how to find a breast cancer localized on the retroglandular clear space ("No man's land") and in the medial portion of the breast. Challenging cases, missed cases and teaching points drawn from the mistakes make this lecture very valuable.

This interactive lecture teaches how to find breast cancers in the retroareolar region and also calls attention on parenchymal contour changes as the only sign of occult breast cancers.

This final lecture provides a didactic approach to the most difficult perception task in mammography: detecting non-calcified architectural distortion.

The ongoing revolution in early detection of breast cancer requires a similar revolution in histopathology technique and changes in terminology

Quick and reliable calcification analysis

Clusters of indistinguishable, powdery, dust-like microcalcifications on the mammograms.

Basic principles. Patient positioning. Cancers localized on the Milky way.

Cancers localized on the Milky way. Continuation of Practice cases.

Cancers localized on the retroglandular clear space (no man's land)

This lecture demonstrates the different types of parenchymal contour changes caused by mammographically occult cancers and helps avoid making mistakes.

Female and male retroareolar breast cancer - implications for sentinel node biopsy technique and long-term patient outcome.

The pathophysiologic process leading to a very special, benign type microcalcifications on the mammogram are described in this lecture.

Seldom seen and troublesome microcalcifications: continuation of case demonstration of Weddellites (calcium oxalate crystals) and skipping stone-like calcifications in fibrocystic change.

This is the second part of two lectures dealing with a particularly challenging breast malignancy, the diffusely infiltrating breast cancer with very special clinical and imaging features.

Professor Gillian Newstead has generously donated two lectures, free of charge, for the audience of Mammography Education, Inc. The objective of this lecture is to assess the clinical role of breast MRI for patient selection and the detection, diagnosis and monitoring the treatment of breast disease.

Professor Gillian Newstead's very interesting lecture describes the History of magnetism in general and breast MRI in particular. Her lecture takes us to a fascinating journey that helps us understand the evolution of this very useful imaging modality.

Invited by the American College of Radiology, László Tabár presented this lecture covering one of the most challenging subtypes of breast malignancy, the diffusely infiltrating breast cancer (a k a diffuse invasive lobular carcinoma). Our research group challenges the conventional histopathology terminology since we have accumulating evidence that this subtypes originates from the mesenchymal stem cells.

Dr. Tom Stavros, an internationally renowned leader in the diagnosis and differential diagnosis of breast diseases using hand-held ultrasound has generously donated this (free of charge) lecture for teaching correlation of ultrasound findings with large format thin and thick section histopathology images. This helps radiologists understand the details of the ultrasound image.

In this lecture Dr. Stavros correlates the ultrasound features of breast masses with the well known immunohistochemical biomarkers of breast cancer.

Dr. Stavros discusses the qualitative and semi-quantitative value of the ultrasound features as diagnostic and prognostic biomarkers in correlation with the BIRADS diagnostic scores.

Dr. Stamatia Destounis, the Director of the Wende Logan Breast Center in Rochester is one of the leaders in the multimodality approach to the detection and diagnosis of breast diseases, generously donated this lecture (free of charge) for the audience of MEI. Dr. Destounis' lecture covers the evolution of digital breast tomosynthesis and provides excellent advice for improving sensitivity when imaging dense breast tissue.

Dr. Stamatia Destounis, shares her experience in imaging women with dense breasts using the combination of ultrasound in addition to FFDM in both screening and clinical practice. Excellent examples enhance the message Dr. Destounis shares in this lecture.

Dr. Susan Roux, an eminent breast radiologist with several decades of experience in breast imaging in private practice is one of the pioneers of developing and testing automated breast ultrasound (ABUS). In this lecture Dr. Roux provides an excellent overview of this new breast imaging technique and describes its practical application.

Imaging women with dense breast is a considerable problem, causing a lower sensitivity in finding benign and malignant lesions hiding in the dense fibroglandular tissue.  The combination of FFDM and automated breast ultrasound (ABUS) is a promising solution to screening women with dense breasts.

This lecture demonstrates the most frequently occurring benign type microcalcifications that are localized outside the ducts and TDLUs.

The lecture series "Asymmetric densities with no associated microcalcifications on the mammogram" provide the radiologists detailed, practical information from the basics through the most complex breast malignancies.

The lecture series "Asymmetric density on the mammogram with no associated microcalcifications" is interactive, involving the audience in the screening process and the immediate workup of the finding uses the multimodality approach to arrive at the correct diagnosis.

These lectures comprise PART III in the lecture series "Asymmetric density on the mammogram with no associated microcalcifications".

The continuation of the lecture series "Asymmetric density with no associated microcalcifications" challenges also the experienced imaging expert.

This is PART V. in the series of "Asymmetric density on the mammogram with no associated microcalcifications". The first part deals with a potential solution for examining women with dense breasts, the rest of the lecture explains tumor growth rates, worsening of the malignancy grade during tumor growth in acinar adenocarcinoma of the breast.

Multifocal and diffuse carcinomas - the main topic of this lecture - presents scientific evidence to support the conclusion: multifocality is an independent negative prognostic factor. Case demonstrations follow.

The most complex acinar adenocarcinoma cases, presented in this lecture, are those where the presence of extensive but occult carcinoma of ductal origin (DAB) causes surprise for the breast imager. Proper selection of the diagnostic tools help solving most of the perception and differential diagnostic problems.

Continuation of case demonstrations where the extensive, diffuse DAB (cancer originating in the major lactiferous ducts) is occult. Assessing the true extent of the disease requires the use of most of the diagnostic tools in these complex cases.

After a short review of the imaging biomarkers, this lecture shows the initial cases in the long series when the non-calcified asymmetric density is associated with architectural distortion, representing the most challenging and highly fatal, diffusely infiltrating breast malignancy.

Interactive case demonstration of difficult to perceive, complex architectural distortion cases with no associated microcalcifications.

This interactive lecture presents normal cases alternating with very complex cases, and summarizing the valuable teaching points at each case.

Following the demonstration of the scientific evidence supporting regular participation in mammography screening as opposed to non-participation and irregular participation, the lecture continues presenting difficult cases of extensive, diffusely infiltrating carcinoma.

One needs to look at and study as many cases of imaging-histopathologic-outcome correlation of the diffusely infiltrating breast cancer of mesenchymal stem cell origin as possible. This lecture series provides unusually large number of cases.

Following a short introduction, demonstration of diffusely infiltrating breast cancers of mesenchymal stem cell origin (also called diffusely infiltrating lobular carcinoma) continues, case after case.

Each lecture involves the audience in the screening process and the immediate workup of the finding, using the multimodality approach to arrive at the correct diagnosis.

Demonstration of diffusely infiltrating breast cancer cases of mesenchymal stem cell origin continues. Interaction with the audience enhances the learning experience.

Unique workup of each diffuse breast cancer correlates the imaging findings with large format histopathology in order to be able to demonstrate that the findings are a reflection of the underlying histopathology. Studying the low power histologic image of each breast cancer subtypes helps understanding the capabilities and limitations of breast imaging tools.

Although the diffusely infiltrating breast cancers of mesenchymal stem cell origin account for about 5-8% of all breast cancers, they have a high fatality rate, therefore this lecture series includes many examples in an interactive presenting style.

The lecture series "Asymmetric densities with no associated microcalcifications on the mammogram" provide the radiologists detailed, practical information from the basics through the most complex breast malignancies.

Cases originating in the major lactiferous ducts may present on the mammogram as non-specific asymmetric density with architectural distortion, but without associated microcalcifications. The interactive case presentation challenges the radiologists.

Continuation of very difficult, challenging cases with useful, practical teaching points summarizing each case.

Real-time demonstration of large format thin section histopathology, comparing the four basic building blocks of normal breast parenchyma with the cancerous tissue distending and distorting the normal structure.  This comparison is very educational for radiologists, surgeons and oncologists. The lecture also shows the first diffuse DAB case with fluid producing carcinoma of ductal origin.

Multimodality workup of diffuse, fluid producing carcinoma of ductal origin. Complex, challenging cases, also for the experienced breast imager.

Interactive demonstration of complex, extensive, fluid producing breast cancer cases of ductal origin (DAB).

This lecture describes a single case that represents a very important group of breast cancers we call duct forming invasive carcinoma / carcinoma of ductal origin (DAB). Dr. Lana Rezan donated this tragic case for teaching. We strongly recommend for every member of the diagnostic and therapeutic teams to watch it and learn from it. The most important message is that the current histopathologic terminology calls this group of highly fatal breast cancers "DCIS". This misnomer misleads the surgeons who perform breast conserving surgery on these cases, often leaving a part of the aggressive cancer behind that harms the patient. The pathologists determine the immunohistochemical biomarkers from the associated acinar adenocarcinoma of the breast which misleads the oncologists. The teaching points of this video meant to be an eye-opener for everybody diagnosing and treating breast cancer patients.

This is unique collection of intracystic tumors, their preoperative workup, correlation with large format histopathology and management. The second half of the lecture is a continuation of the noncalcified architectural distortion series.

Extensive, non-calcified, fluid-producing, complex cases are easier to understand when correlating with large format thin and thick section histopathology.

The unique feature of the cases presented in this lecture is the presence of serous or bloody nipple discharge, while the extensive disease may be occult for mammography.  It is the cancer cells - having micropapillary and/or cribriform tumor growth pattern - that produce the fluid.

Mammographically occult, fluid producing carcinoma cases originating in the major ducts. The results of the multimodality workup are compared with large format thin and thick section histopathology.

Continuation of extensive, non-calcified, fluid-producing carcinomas originating in the major ducts and duct-like structures. Preoperative workup results are explained when comparing with large format this section and 3D histopathology images.

Granular cell tumor, traumatic fat necrosis and radial scar are benign breast diseases that can mimic breast malignancy, therefore it is important to understand the underlying pathophysiologic processes.

Continuation of the lecture about radial scar. Diagnosis, differential diagnosis, tricks of the trade.

The final lecture about radial scar. The second part of the lecture deals with Juvenile papillomatosis (Swiss cheese disease).

3D histopathology demonstrates the structural elements of the normal breast tissue and the alterations caused by benign and malignant breast diseases. Breast imaging-3D histopathologic correlation can be considered the "Mother of knowledge" for every breast imager.

In the following lecture series the main emphasis is placed upon explaining the underlying pathophysiologic process for each microcalcification subtype,  providing solid knowledge for the radiologists when analyzing microcalcifications. This lecture describes the very first steps in analyzing calcifications and details most of the miscellaneous calcifications.

At the beginning of this lecture the description of the Weddellites closes the description of the Miscellaneous type calcifications, followed by an overview of the microcalcifications formed within the TDLUs and major ducts.

Malignant type calcifications within the major lactiferous ducts: overview and detailed description of the imaging biomarkers of DAB.

Fragmented casting type calcifications: constant correlation of the mammographic findings with large format thin and subgross, thick section (3D) histopathology images. Diagnosis, different diagnosis, pitfalls.

Continuation of the description of fragmented casting type calcification cases correlated both to histopathology and long-term outcome.

The description of calcified breast cancers of ductal origin is grouped according to different teaching points. This and the following lectures demonstrate representative cases supporting the individual teaching points.

Detailed description of casting type calcifications cases with fatal outcome.

Continuation of the presenting casting type calcifications cases, their extent, presence in axillary lymph node metastases and a video showing an unexpectedly fatal case.

Presentation of a mixture of casting type calcification cases to solidify knowledge and gain respect for this misunderstood, underdiagnosed, but potentially fatal breast cancer subtype.

Casting type calcifications on the mammogram - description of cases with poor long-term outcome.

Dotted and fragmented casting type calcifications on the mammogram - representing a breast cancer subtype with poor long-term prognosis

Case-based analysis of malignant type calcifications using multimodality approach and histologic correlation.

Subgross, thick section histopathology images help bridge the gap between the appearance of breast cancer at preoperative imaging and its appearance on thin section histopathology and has provided crucial visual evidence for the apparent sites of origin of breast cancer subtypes.

This lecture is PART I of the oral presentation and interpretation of the article published in the European Journal of Radiology: https://www.dropbox.com/s/h2vpp7ls24zws69/Article%20pdf.pdf?dl=0  

This lecture is PART II of the oral presentation and interpretation of the article published in the European Journal of Radiology: https://www.dropbox.com/s/h2vpp7ls24zws69/Article%20pdf.pdf?dl=0  

Prof. László Tabár's mini course at the European Journal of Radiology's Aug 20th, 2022 Summer School had the following main chapters: 1) Imaging-large format subgross (3D) histopathologic correlation of the four basic building blocks of the normal breast parenchyma to help understanding the benign, hyperplastic breast diseases and different types of breast cancers   2) How to view a mammogram 3) A new classification of breast cancers according to their site of origin  4) Imaging biomarkers: detailed description and interactive presentation of breast cancers developing from the TDLUs, from the major lactiferous ducts and from the mesenchymal stem cells 5) Demonstration of the most frequent locations on the mammogram where breast cancers can be found.

  Prof. László Tabár's mini course at the European Journal of Radiology's Aug 20th, 2022 Summer School had the following main chapters: 1) Imaging-large format subgross (3D) histopathologic correlation of the four basic building blocks of the normal breast parenchyma to help understanding the benign, hyperplastic breast diseases and different types of breast cancers   2) How to view a mammogram 3) A new classification of breast cancers according to their site of origin  4) Imaging biomarkers: detailed description and interactive presentation of breast cancers developing from the TDLUs, from the major lactiferous ducts and from the mesenchymal stem cells 5) Demonstration of the most frequent locations on the mammogram where breast cancers can be found.

Prof. László Tabár's mini course at the European Journal of Radiology's Aug 20th, 2022 Summer School had the following main chapters: 1) Imaging-large format subgross (3D) histopathologic correlation of the four basic building blocks of the normal breast parenchyma to help understanding the benign, hyperplastic breast diseases and different types of breast cancers   2) How to view a mammogram 3) A new classification of breast cancers according to their site of origin  4) Imaging biomarkers: detailed description and interactive presentation of breast cancers developing from the TDLUs, from the major lactiferous ducts and from the mesenchymal stem cells 5) Demonstration of the most frequent locations on the mammogram where breast cancers can be found.

Prof. László Tabár's mini course at the European Journal of Radiology's Aug 20th, 2022 Summer School had the following main chapters: 1) Imaging-large format subgross (3D) histopathologic correlation of the four basic building blocks of the normal breast parenchyma to help understanding the benign, hyperplastic breast diseases and different types of breast cancers   2) How to view a mammogram 3) A new classification of breast cancers according to their site of origin  4) Imaging biomarkers: detailed description and interactive presentation of breast cancers developing from the TDLUs, from the major lactiferous ducts and from the mesenchymal stem cells 5) Demonstration of the most frequent locations on the mammogram where breast cancers can be found.

Prof. László Tabár's mini course at the European Journal of Radiology's Aug 20th, 2022 Summer School had the following main chapters: 1) Imaging-large format subgross (3D) histopathologic correlation of the four basic building blocks of the normal breast parenchyma to help understanding the benign, hyperplastic breast diseases and different types of breast cancers   2) How to view a mammogram 3) A new classification of breast cancers according to their site of origin  4) Imaging biomarkers: detailed description and interactive presentation of breast cancers developing from the TDLUs, from the major lactiferous ducts and from the mesenchymal stem cells 5) Demonstration of the most frequent locations on the mammogram where breast cancers can be found.