Department of Radiology

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. 

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 (largely split between two breast fellows). 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.

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 research projects are listed below:

Oral Presentations:

  1. Zuckerman SP, Conant EF, Weinstein S, Synnestvedt M, Korhonen K, McDonald E. Impact on recall rates following implementation of synthesized 2D mammography in digital breast tomosynthesis screening. Radiological Society of North America (RSNA) 101st Scientific Assembly and Annual Meeting; December 2015; Chicago, IL.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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; December 2013; Chicago IL.
  7. 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; May 2014; San Diego, CA. 
  8. 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.
  9. 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.

Posters:

  1. J Gillman, MD, Philadelphia, PA, EF Conant, MD, ES McDonald, MD, S Weinstein, MD. Abbreviated Breast MRI for Surveillance: A Retrospective Pictorial Essay. Educational Exhibit. Radiologic Society of North America (RSNA) 103rd Scientific Assembly and Annual Meeting; 2017; Chicago, IL.
  2. A Elmi, MD, EF Conant, MD, A Kozlov, MD, ES McDonald, MD, Scientific Poster. Awarded Student Travel Stipend Performance of Pre-operative Breast MRI in Newly Diagnosed Cancer: Comparison of Outcomes Based on Mammographic Modality, Breast Density and Breast Parenchymal Enhancement. Radiologic Society of North America (RSNA) 103rd Scientific Assembly and Annual Meeting; 2016; Chicago, IL. 
  3. A Kozlov, MD, EF Conant, MD, A Elmi, MD, S W MD, ES McDonald, MD. Preoperative Breast MR in Women with Digital Breast Tomosynthesis (DBT) versus Conventional Digital Mammography (DM) Diagnosed Breast Cancer: Do Mammographic Density and MR Background Parenchymal Enhancement (BPE) Affect MR Performance? Educational Exhibit, Radiologic Society of North America (RSNA) 103rd Scientific Assembly and Annual Meeting; 2016; Chicago, IL.
  4. Korhonen K, Weinstein SP, Conant EF, Zuckerman SP, Synnestvedt M, McDonald EM. Screen Detected Breast Cancer Conspicuity on Digital Breast Tomosynthesis versus Digital Mammography. Radiological Society of North America (RSNA) 101st Scientific Assembly and Annual Meeting; December 2015; Chicago IL . BR235-SD-MOB3.
  5. Korhonen K, Weinstein SP, McDonald EM, Zuckerman SP, Conant EF. Strengths and Shortcomings of Digital Breast Tomosynthesis: Review of Cancers Detected as well as those "Missed" in a Population-based Screening Program. Radiological Society of North America (RSNA) 101st Scientific Assembly and Annual Meeting; December 2015; Chicago IL. BR111-ED-SUB5.
  6. Zuckerman SP, Conant EF, Weinstein S, Korhonen K, Synnestvedt M, McDonald ES. Early implementation of synthesized 2D in screening with digital breast tomosynthesis: a pictorial essay of early outcomes. Radiological Society of North America (RSNA) 101st Scientific Assembly and Annual Meeting; December 2015; Chicago, IL. 
  7. 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; 2012; Chicago, IL. 
  8. 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; June 2013, Philadelphia, PA. Symposium held by the Department of Radiology at the Hospital of the University of Pennsylvania, Philadelphia, PA.
  9. 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; December 2013; San Antonio, TX.
  10. 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. Radiological Society of North America 2013 Scientific Assembly and Annual Meeting; December 1 - December 6, 2013; Chicago IL.
  11. 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 2014 Scientific Assembly and Annual Meeting; 2014; Chicago, IL.
  12. 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

Oral Presentations

2015 National RSNA Trainee Research Prize
Zuckerman SP, Conant EF, Weinstein S, Synnestvedt M, Korhonen K McDonald E. Impact on recall rates following implementation of synthesized 2D mammography in digital breast tomosynthesis screening. Radiological Society of North America (RSNA) 101st Scientific Assembly and Annual Meeting; December 2015; Chicago, IL.

2014 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) 100th Scientific Assembly and Annual Meeting; December 2015; Chicago, IL.

2013 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.

Posters

2015 Magna Cum Laude Educational Exhibit
Zuckerman SP, Conant EF, Weinstein S, Korhonen K, Synnestvedt M, McDonald E. Early implementation of synthesized 2D in screening with digital breast tomosynthesis: a pictorial essay of early outcomes. Radiological Society of North America (RSNA) 101st Scientific Assembly and Annual Meeting; December 2015; Chicago, IL.

2015 Magna Cum Laude Educational Exhibit
Korhonen K, Weinstein SP, McDonald EM, Zuckerman SP, Conant EF. Strengths and Shortcomings of Digital Breast Tomosynthesis: Review of Cancers Detected as well as those "Missed" in a Population-based Screening Program. Radiological Society of North America (RSNA) 101st Scientific Assembly and Annual Meeting; December 2015 Chicago IL. BR111-ED-SUB5.

  • Award: Magna Cum Laude
  • Award: Identified for RadioGraphics

Recent Resident and Fellow Publications in Breast Imaging

  1. Zuckerman SP, Maidment ADA, Weinstein SP, McDonald ES, Conant EF. Imaging With Synthesized 2D Mammography: Differences, Advantages, and Pitfalls Compared With Digital Mammography. AJR Am J Roentgenol. 2017 Jul;209(1):222-229. Epub. 2017, May 2.
  2. Chudgar AV, Conant EF, Weinstein SP, Keller BM, Synnestvedt M, Yamartino P, McDonald ES. Assessment of disease extent on contrast-enhanced MRI in breast cancer detected at digital breast tomosynthesis versus digital mammography alone. Clin Radiol. 2017 Jul;72(7):573-579. Epub. 2017, Mar 17.
  3. Korhonen KE, Weinstein SP, McDonald ES, Conant EF. Strategies to Increase Cancer Detection: Review of True-Positive and False-Negative Results at Digital Breast Tomosynthesis Screening. Radiographics. 2016 Nov-Dec;36(7):1954-1965. Epub. 2016, Oct 7.
  4. Zuckerman SP, Conant EF, Keller BM, Maidment AD, Barufaldi B, Weinstein SP, Synnestvedt M, McDonald ES. Implementation of Synthesized Two-dimensional Mammography in a Population-based Digital Breast Tomosynthesis Screening Program. Radiology. 2016 Dec;281(3):730-736. Epub. 2016, Jul 28
  5. Wu S, Weinstein SP, DeLeo MJ III, Conant EF, Chen J., Domchek SM, 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.
  6. DeLeo M.J. III, Domchek S, Kontos D, Conant E, Chen, J, Weinstein SP. 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.
  7. 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.

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.

Application

The Penn Breast Imaging Fellowship is planning to participate in the fellowship match for the entering class of 2019. 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:

  • Penn Fellowship Application Form
  • Transcript of Medical School Record and Dean's Letter.
  • Letter of recommendation from your program director.
  • 2 Additional letters of recommendation from 2 physicians who know you well.
  • 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.
  • Curriculum Vitae
  • ECFMG certificate (if applicable)
  • USMLE STEP scores

Program Director

Emily F. Conant, MD
Division Chief, Breast Imaging
Vice Chair, Faculty Development, Radiology
Professor of Radiology, the Hospital of the University of Pennsylvania

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