Breast Imaging Fellowship

The growth of the mammography service at UMass Memorial began with the arrival of Dr. Edward Smith in 1980 as the second Chair of the department. He brought with him Dr. Carl D'Orsi as Vice Chair and Director of  Breast Imaging. The section's volume grew consistently over time and additional mammographers were recruited to handle the volume of imaging and procedures. The Breast Imaging Division has been very active in clinical and medical physics research over the years. In the late 1990’s, the department was awarded a grant from the Department of Defense to compare full-field digital mammography and screen-film mammography for the detection of breast cancer in a screening population.  This was a collaborative effort between UMass, the University of Colorado and General Electric. This research ushered the new era of digital mammography that is now the gold standard.  With the participation of radiologists from this Division as expert readers, the clinical data was used by General Electric to obtain FDA approval of the first digital mammography system in the United States.      

Workload:
We are a high volume comprehensive Breast Imaging Division that performs approximately 43,000 examinations annually between our four campuses. Approximately 26,500 screening examinations, 7,000 diagnostic studies, 5,000 ultrasound examinations, 2,500 interventional procedures (includes stereotactic, ultrasound, MRI guided biopsies, needle localization prior to surgical excision and sentinel node injections) and 500 MR breast examination studies are interpreted annually. In addition, mammograms are performed at Tri-River and Barre facilities affiliated to the UMass group and are also read by our specialists.

Accreditation:
The Comprehensive Breast Center was accredited by the NAPBC (National Accreditation Program for Breast Centers affiliated with the American College of Surgeons) in July 2012. Quality, documentation and accreditation of the Breast Imaging facility were all important criteria for this accreditation. The Breast Imaging facility at ACC and the Memorial Campus have both been designated as a “Center of Excellence”, by the American College of Radiology (ACR) in early 2012. The Hahneman and Shrewsbury screening sites and the satellite locations at Barre and Tri-river are both ACR accredited and FDA approved as well.

Faculty

Positions Available: 1
Length of Fellowship: 12 months
ACGME: No
Application Dates: We accept applications all year round
Interview Dates: November/December

Program Goals

The Breast Imaging Fellowship will provide advanced training in multi-modality breast imaging and its applications.  Fellows will be involved in all aspects of patient care and will learn to screen healthy patients utilizing multi-modality breast imaging as well as direct appropriate imaging work-up for patients in diagnostic breast imaging.  Advanced training will be provided in digital mammography, tomosynthesis, breast ultrasound and breast MRI.

Fellows will be trained in the selection and performance of all breast related procedures and in the necessary follow-up of results for radiology-pathology correlation, determination of concordance and appropriateness of follow-up recommendations.

Fellows will also be allowed the opportunity to function as an integral member of the breast care center communicating with patients, referring physicians and other specialists involved in the care of breast cancer patients.

Another program goal includes engaging fellows in scholarly activities such as presentations at interdisciplinary breast conferences and tumor boards, quarterly journal clubs, in the preparation of two resident conferences and in clinical research including the potential for presentations at local and/or national conferences.

Breast Imaging Breast Imaging

Curriculum

Breast Imaging Curriculum

The Breast Imaging Division of the UMass Radiology Department is staffed by 7, fellowship-trained radiologists who are committed to medical student training and graduate medical education. We are a NAPBC approved Comprehensive Breast Center, and ACR designated Center of Excellence. Currently 42,000 mammograms, 5,000 dedicated breast ultrasound, 500 breast MRI and 4,000 interventional procedures are performed annually. The environment is completely digital with a dedicated Aurora breast MRI , two tomosynthesis units, four dedicated ultrasound suites and a dedicated coned beam breast CT unit.

Breast Imaging fellows are an integral member of the Division, interpreting screening and diagnostic mammogram, ultrasound and MRI. Fellows also perform ultrasound guided biopsies, stereotactic biopsies, MR guided biopsies, and needle localizations. Breast fellows rotate between our University Campus and our Memorial Campus in order to get exposed to academic breast imaging as well as community breast imaging.

Fellows are exposed to a diverse patient population and wide range of breast pathology. The fellow works closely with the breast surgeons, pathologists and oncologist at UMass Memorial Medical Center as an integral part of the interdisciplinary team.

The fellow's responsibilities include assisting the attending staff in resident education and training. The fellow has opportunities to present at the weekly interdisciplinary breast tumor board as well as at the bimonthly radiology pathology correlation conference.

In addition to clinical activities, fellows are trained in research methodology, manuscript preparation, and other activities essential to an academic career and objective interpretation of medical literature. Recent fellows have been able to participate in research on the regions only breast CT.

Discretion

UMMS Breast Imaging Discretion

Medical Physicists, Drs. Andrew Karellas, Stephen Glick and Srinivasan Vedantham coordinate the research efforts in the Breast Imaging Division.  The research section of the Division is internationally known for its accomplishments in this field. A number of research proposals have been submitted to the NIH and are pending review. 

Discretion at various planning stages includes x-ray phase contrast imaging of the breast, assessment of quantitative breast cancer risk through imaging, imaging of microcalcifications with tomographic x-ray techniques, breast PET/CT, and imaging for tumor response to neoadjuvant chemotherapy.  

Thanks to the generous philanthropic support from a number of donors in the community, we were able to procure a unique dedicated breast CT system that will be used for research purposes (one of six centers worldwide).  This imaging system is manufactured by Koning Corporation (West Henrietta, NY) and it is an experimental device (not FDA approved).  It acquires true tomographic and 3D images of the breast without physical compression of the breast.  The role of contrast enhanced breast CT in the evaluation of lobular cancers is currently being investigated under an institutional approved IRB protocol.

Conferences

breast conference- dr watkins and dr debenedectis shown

Every Wednesday, there is an interdisciplinary (involves the disciplines of medical and radiation oncology, radiology, pathology, surgery, genetics and behavioral health) breast conference held at the ACC complex, where the imaging findings, pathology and clinical plan for all newly diagnosed breast cancer cases are discussed.

On the 2nd and 4th Tuesday evenings of every month, another interdisciplinary conference (rad-path correlation) is held, where any discordance in imaging finding and biopsy are discussed, in  addition, cases with interesting and challenging imaging findings are also discussed. This helps evolve possible algorithms for follow-up. Each session is preceded by a brief lecture on an interesting aspect of breast cancer management by a senior faculty from different disciplines.

In addition, didactic monthly noon-conferences and case presentations for the residents are routine.

Radiology Grand Rounds are held throughout the year with visiting and local professors offering the opportunity to meet and learn from leading national authorities on a wide variety of topics.

The Division strives to maintain a high quality of resident and fellowship education with stress on the six focus area outlined in the Clinical Learning Environment Review program.

Imaging Facilities / Locations

Breast Imaging

The Breast Imaging Division of the UMass Memorial Health Group is an “all digital” mammography division spread across four campuses within a 2 mile radius located at the Ambulatory Care Center (ACC) of the University Campus, the Memorial Campus, the Hahneman Campus and the Shrewsbury Complex. In addition, we also provide screening coverage to two satellite locations at Barre and Tri-River.

Southboro Medical Group and Marlboro Hospital are our new community locations where we perform screening mammography, diagnostic mammography, breast ultrasound, breast MRI, and image guided interventions. At Clinton Hospital we offer diagnostic mammography and ultrasound, as well as screening mammography and ultrasound guided breast biopsies.

At the Hahneman and Shrewsbury Complex only screening mammography is performed. Breast MRI is performed at the Belmont Street facility across the Memorial Campus. The main breast imaging section is located adjacent to the Comprehensive Breast Clinic on the 5th floor of the ACC complex. Majority of diagnostic breast imaging along with breast ultrasound and interventional procedures are done at ACC. Pre-surgical needle localizations, some diagnostic work along with MRI reads and a large volume of the mammography screening examinations are performed at the Memorial Campus.

Currently, the Division has four Hologic Dimensions unit (two with tomosynthesis capability), ten Hologic Selenia units, five Philips IU-22 ultrasound units, one Lorads Stereotactic unit and two Kubtec specimen x-ray units.

Information and Application

Positions Available: 1
Length of Fellowship: 12 months
ACGME: No
Application Dates: We accept applications all year round
Interview Dates: November/December

Contact Information:
Kathy Delongchamp
Fellowship Program Coordinator
Tel: 111.111.5740
Fax: 111.111.1860
[email protected]

Requirements:
Applicants must have completed a radiology residency program accredited by the ACGME by the time they begin their fellowship at UMMMC. Applicants must be certified or eligible for certification by the American Board of Radiology (ABR) or equivalent. Acceptance is contingent on obtaining an unrestricted Massachusetts medical license by start date of Fellowship.

Applications must include:

  • Fellowship Application (click here to download PDF)
  • Personal Statement
  • Curriculum vitae
  • Three letters of recommendations, one of which must be from your residency program director
  • USMLE Scores
    • Fellowship applicants need to have passed ALL USMLE scores, Step 1, Step 2CK, Step 2CS and Step 3.
    • Applications that are missing USMLE Step 3 will not be considered.
  • Medical school transcript
  • Deans Letter

Candidates will be considered for interviews only after completed applications are received.
Completed applications should be addressed to the Program Director and submitted to:
Breast Imaging Fellowship Program
Attention: Kathy Delongchamp
Department of Radiology, Room S2-302
University of Massachusetts Medical School
Lake Avenue North
Worcester, MA