Breast Imaging

Breast Imaging Fellowship

The Division of Breast Imaging at the Hospital of the University of Pennsylvania is pleased to offer a comprehensive one-year experience in breast imaging. Rotations in the Breast Imaging section provide extensive clinical training in multimodality screening, diagnostic, and interventional breast imaging. Interdisciplinary experiences in breast surgery, breast oncology, radiation oncology, and breast pathology are integral parts of the curriculum. A community radiology breast imaging rotation is also available if desired.

Breast Imaging

The Section of Breast Imaging, Department of Radiology, University of Pennsylvania Medical Center Perelman Center for Advanced Medicine performs approximately 22,000 mammograms and approximately 2000 interventional breast procedures a year. The breast imaging center occupies approximately 5,900 square feet and contains 5 full-field digital mammographic units of which 4 are capable of digital breast tomosynthesis, 3 dedicated breast ultrasound machines, a prone table stereotactic biopsy unit with digital acquisition and display capabilities (Lorad), and a dedicated breast MRI unit.

The fellow, under attending supervision, performs a wide range of breast biopsy procedures including stereotactic biopsies, ultrasound guided core biopsies, MRI-guided core biopsies, and needle localizations using mammographic, ultrasound, tomosynthesis and MRI guidance. The fellow also actively participates in mammographic interpretation and diagnostic sonographic evaluation. There is active didactic teaching on the clinical service. There are 6 attendings on the service, which gives the fellow exposure to a wide range of styles and approaches to breast imaging.

The fellow is involved in the organization of the monthly mammographic-pathology conference. During the conference, we discuss interesting biopsy proven cases with pathologic correlation provided by the Pathology department. Active participation in the bi-weekly multidisciplinary breast cancer conference is also supported. There are ample resident teaching opportunities while on service and at dedicated resident teaching conferences.

Fellowship Goal

The goal of the fellowship is to train specialists in Breast Imaging — top-notch individuals in the field who are highly qualified for directing a large private breast imaging center or to enter an academic career. Penn fellows are highly sought after in the job market.

Research

Many mentored research opportunities are available on the Breast Imaging service. Multiple breast imaging related research activities are ongoing in the Department including tomosynthesis, ultrasound and MRI research. The fellow is strongly encouraged to participate in a research project. Recent resident and fellow projects are listed below:

Current Resident and Fellow Research Projects in Breast Imaging

  1. Aromatherapy to improve the biopsy experience
  2. Clinical implementation of 2D reconstructed images for use with tomosynthesis (2 abstracts submitted RSNA 2015).
  3. Digital mammography versus digital breast tomosynthesis conspicuity study (2 abstracts submitted RSNA 2015)
  4. Development of novel biomarkers for breast cancer imaging (in progress).
  5. Cell culture work for biomarker evaluation (in progress).
  6. Translational animal model work for biomarker evaluation (in progress).
  7. Large scale genomic analysis for biomarker development (abstract accepted for AACR 2014).
  8. Breast MRI and benign biopsy follow-up (poster and oral presentation, RSNA and SABC).
  9. Tomosynthesis and MRI utilization (RSNA 2014, National Trainee Research Paper Prize).

Trainee Presentations in Breast Imaging

Oral Presentations:

  1. Den EI., Weinstein SP., Roth, SG. "Cancer Detection Rate on Short-Term, as well as Long-erm Follow-up MRI After a Benign Concordant MRI-Guided Breast Biopsy." Radiological Society of North America (RSNA) 99th Scientific Assembly and Annual Meeting, Chicago IL (December 2013).
  2. Thomas M, Roth RG, McCarthy AM, Conant EF. "Improved Conspicuity of Architectural Distortion with Digital Breast Tomosynthesis Increases Radial Sclerosing Lesion detection during Prospective Breast Cancer Screening," Oral Presentation at ARRS meeting; San Diego, CA, May 2014.
  3. Thomas M, Chui JH, Conant EF, Maidment AD. A clinician-friendly, automated framework for radiation dose report generation and real-time analysis of institution-wide clinical mammography and digital breast tomosynthesis studies. ARRS 2014.
  4. Akhtar A, McCarthy AM, Synnestvedt M, Conant EF. Comparison of baseline screening callback and cancer detection rates for digital mammography versus digital breast tomosynthesis at a large urban academic center ARRS 2014.
  5. Chudgar A, McDonald E, Weinstein SP, Yamartino PA, Synnestvedt M, Conant EF. Digital Breast Tomosynthesis versus Digital Mammography Detected Cancers: Assessment of Disease Extent on MRI. Radiological Society of North America (RSNA), 2014; Chicago IL.
  6. Weinstein SP, Chudgar A, McDonald E, Yamartino PA, Synnestvedt M, Conant EF. Utilization of MRI as a Problem Solving Tool Prior to and Following the Implementation of Screening DBT. Radiological Society of North America (RSNA), 2014; Chicago IL.
  7. Shankla V., Pokrajac D.D., Weinstein S.P., DeLeo M.J. III, Tuite C., Roth R., Conant E.F., Maidment A.D.A., Bakic P.R.: Automatic insertion of simulated microcalcification clusters in a software breast phantom. SPIE Medical Imaging, 2014, San Diego, CA.
  8. Dinglasan LV, Schmitt JE, Weinstein S, Conant E, Stavropoulos SW. (2015) Analysis of Trends in Online Information-Seeking Behavior for Breast Tomosynthesis Versus Screening Mammography. [Electronic Exhibit] American Roentgen Ray Society, E5187.

Posters:

  1. Roth RG, Conant EF, Gavenonis SC, Weinstein SP, Tobey J, Birnbaum JA. "Digital Breast Tomosynthesis: Lessons Learned from Early Clinical Implementation," (Educational Exhibit) Presented at RSNA Annual Meeting in Chicago, IL, 2012.
  2. Den EI., Weinstein SP., Roth, SG. "Cancer Detection Rate on Short-Term, as well as Long-Term, Follow-up MRI After a Benign Concordant MRI-Guided Breast Biopsy." 38th Annual Pendergrass Symposium held by the Department of Radiology at the Hospital of the University of Pennsylvania, Philadelphia PA (June 2013).
  3. Den EI., Laguna BA., Weinstein SP., Roth, SG. "Cancer Detection Rate in High-Risk Patients on Short-Term, as well as Long-Term Follow-up MRI After a Benign Concordant MRI-Guided Breast Biopsy." 2013 San Antonio Breast Cancer Symposium, San Antonio TX (December 2013).
  4. Daye, D., Rowland, J., Ashraf, A., Mahrooghy, M., Feldman, M., Rosen, M., Conant, E., Kontos, D. Beyond Conventional Diagnostics: The Emerging Role of Quantitative Magnetic Resonance in Breast Cancer Prognostication and Treatment Response Prediction. RSNA, December 2013.
  5. Chudgar A, McDonald E, Weinstein SP, Yamartino PA, Synnestvedt M, Conant EF. Pictorial Review of Breast MRI Utilization in Two Screening Populations: Digital Mammography versus Digital Breast Tomosynthesis. Radiological Society of North America (RSNA), 2014; Chicago IL.
  6. Wu, S., Weinstein S., DeLeo M.J. III, Domchek S., Schnall M., Conant E., Kontos D.: A Fully Automated Method for Quantifying Fibroglandular Tissue and Background Parenchymal Enhancement in Breast MRI: Towards Personalized Risk Assessment for High-Risk Women. Radiological Society of North America Annual Meeting, 2013, Chicago, IL.

AWARDS AND HONORS

Certificate of Merit - Educational Exhibit, RSNA National Convention November 2012. "Digital Breast Tomosynthesis: Lessons Learned from Early Clinical Implementation." Roth RG, Conant EF, Gavenonis SC, Weinstein SP, Tobey J, Birnbaum JA. Scholarship Recipient, Society of Breast Imaging; April 2011

National RSNA Research Trainee Prize:

Chudgar A, McDonald E, Weinstein SP, Yamartino PA, Synnestvedt M, Conant EF. Digital Breast Tomosynthesis versus Digital Mammography Detected Cancers: Assessment of Disease Extent on MRI. Radiological Society of North America (RSNA), 2014; Chicago IL.

Recent Resident and Fellow Publications in Breast Imaging

  1. Wu S., Weinstein S.P., DeLeo M.J. III, Conant E.F., Chen J., Domchek S.M., Kontos D.. Quantitative assessment of Background Parenchymal Enhancement in breast MRI predicts response to Risk-Reducing Salpingo-Oophorectomy: Preliminary evaluation in a cohort of BRCA1/2 mutation carriers. Submitted to Breast Cancer Research. 2015.
  2. DeLeo M.J. III, Domchek S., Kontos D., Conant E., Chen, J., Weinstein S.P.: Breast MRI Parenchymal Enhancement and Fibroglandular Volume in BRCA1 and BRCA2 Mutation Carriers Before and Immediately After Risk-Reducing Salpingo-Oophorectomy. American Journal of Roentgenology, 204(3):669-73, 2015.
  3. Roth RG, Maidment AD, Weinstein SP, Roth SO, Conant EF. Digital breast tomosynthesis: lessons learned from early clinical implementation. Radiographics. 2014 Jul-Aug;34(4):E89-102.
  4. McDonald, ES, McCarthy, AM, Akhtar, A, Synnestvedt, M, Schnall, M, Conant, EF. Baseline Screening Mammography: Performance of Full Field Digital vs. Digital Breast Tomosynthesis. In press, AJR.

Application

Applications are accepted as of June 1, 2015 and applicants will be admitted on a rolling basis.

Please refer to the how to apply page for additional details, including licensure requirements and any applicable visa requirements.

Please include the following credentials with your application:

  1. Penn Fellowship Application Form
  2. Transcript of Medical School Record and Dean's Letter.
  3. Letter of recommendation from your program director.
  4. 2 Additional letters of recommendation from 2 physicians who know you well.
  5. A letter from you expressing your present thoughts on your long range goals and interests in Breast Imaging. This should include your interests in investigation, teaching and academic activities. A candid statement of your general aims would be appreciated.
  6. Curriculum Vitae
  7. ECFMG certificate (if applicable)
  8. USMLE STEP scores

Contact

Breast Imaging Fellowship
Elizabeth McDonald, MD, PhD Program Contact
Attention: Rosemary DiCicco
Department of Radiology/Breast Imaging
Hospital of the University of Pennsylvania
3400 Spruce Street, 1 Silverstein
Philadelphia, PA 19104

Office: 215-614-0124
Fax: 215-662-7436
Email: rosemary.dicicco@uphs.upenn.edu