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Dr. Jules Sumkin presents a case of a 46-year-old woman with indeterminate calcifications in her left breast. Upon review of her DBT study, an unsuspected area of architectural distortion in the contralateral right breast was discovered. This area was not apparent in the original 2D mammogram, nor was it visible when the patient was recalled for additional mammographic views and targeted ultrasound.

Additionally, Dr. Marguerite Bonaventura presents a 70-year-old female who underwent her annual screening mammogram, during which a nodular density was found in the outer half of the right breast.


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Educational Objectives:

After participating in this educational activity, the participants should be better able to:

  • Describe the role of tomosynthesis as it fits into the breast imaging paradigm
  • Discuss the strengths and pitfalls of tomosynthesis interpretation
  • Explain the technique of RSL in the management of a patient with breast cancer
  • Describe the benefits and drawbacks of RSL when compared to wire localization

Reading Resources:

  1. Park JM, Franken EA, Garg M, Fajardo LL, Niklason LT. Breast Tomosynthesis: Present considerations and future applications. RadioGraphics 2007:27:S231-S240.
  2. Lewin JM, Nikalson L. Advanced applications of digital mammography: Tomosynthesis and contrast enhanced digital mammography. Sem Roentgen; 2007 Elsevier: 243-52
  3. Jakub, James, et al.  “Current Status of Radioactive Seed for Localization of Nonpalpable Breast Lesions,” The American Journal of Surgery, vol.199, no. 4, April 2010, pgs. 522-528.
  4. Lovrics, Peter, et al. “A Multicentered, Randomized, Controlled Trial Comparing Radioguided Seed Localization to Standard Wire Localization for Nonpalpable, Invasive and In Situ Breast Carcinomas,” Annals of Surgical Oncology, Online First, 30 April 2011.


Jules Sumkin, DO, FACR, receives research support from PI Global Research Agreement with Hologic Inc.

Marguerite Bonaventura, MD, reports no relationships with any entities producing health care goods or services.

Accreditation Statement:

The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Pittsburgh School of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 CreditsTM. Each physician should only claim credit commensurate with the extent of their participation in the activity. Other health care professionals are awarded (0.05) continuing education units (CEU) which are equivalent to 0.5 contact hours.

For your credit transcript, please access our website 4 weeks post-completion at and follow the link to the Credit Transcript page. If you do not provide the last 5 digits of your SSN on the next page you will not be able to access a CME credit transcript. Providing your SSN is voluntary.

Release Date: 1/17/2012 | Last Modified On: 4/01/2013 | Expires: 4/01/2014

This course has been expired.