Rita Freimanis, MD

Professor, Clinical Radiology


Rita Freimanis, MD, is professor of clinical radiology in the Breast Imaging section at the University of California, San Francisco Mount Zion. She obtained her medical degree from Bowman Gray School of Medicine, Winston-Salem, North Carolina in 1985. In 1990, she completed her four-year Diagnostic Radiology residency program at the North Carolina Baptist Hospital/Bowman Gray School of Medicine in Winston-Salem. Before Dr. Freimanis came to UCSF, she was a professor in the department of radiology at Wake Forest University School of Medicine, as well as the previous Section Head of Breast Imaging, Director of the Breast Imaging Fellowship Program, Radiology Residency Program Director and Vice-Chair of Education.

Dr. Freimanis’ research interests include collaborating with other clinicians and basic scientists in areas related to breast imaging and breast cancer. She has experience in the evaluation of advance technologies such as stereotactic core needle biopsy, Homologous Electrical Differences Analysis (HEDA), Positron Emission Mammography (PEM), and digital mammography, looking at soft­copy versus film display and computer aided detection. Overall, Dr. Freimanis believes in the importance of anticipating needs of the next generation of patients and imagers, and working to maintain top quality breast imaging services for patients.

Dr. Freimanis was for many years an invited examiner for the American Board of Radiology and clinical image reviewer for the American College of Radiology mammography accreditation program. She has directed over 20 breast cancer and breast imaging CME meetings. She has 9 book chapters, 29 journal articles and over 100 invited presentations.

Dr. Freimanis provides many years of experience related to breast imaging, and her expertise in breast cancer, radiology, and education is recognized nationally and internationally.

Breast Imaging

Breast cancer, breast imaging

Professional Interests:
Mammography, breast ultrasound, breast MRI, image­guided breast biopsy, multidiscipline breast cancer approach, breast tomosynthesis

Education and Training:
• Medical School: Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina
• Residency: North Carolina Baptist Hospital/Bowman Gray School of Medicine, Winston-Salem

Honors and Awards

Elected Fellow, American College of Radiology, 2003
James L. Quinn III, MD Award For Teaching Excellence, Wake Forest School of Medicine, Radiology, 1998-2015
Outstanding Resident Award, Wake Forest Radiology, 1990
Best Female Medical Student, Bowman Gray SOM, American Medical Women’s Association Certificate of Merit, 1985
Alpha Omega Alpha Medical Honor Society, Wake Forest University School of Medicine, 1985


Glencer AC, Miller PN, Greenwood H, Maldonado Rodas CK, Freimanis R, Basu A, Mukhtar RA, Brabham C, Kim P, Hwang ES, Rosenbluth JM, Hirst GL, Campbell MJ, Borowsky AD, Esserman LJ. Identifying Good Candidates for Active Surveillance of Ductal Carcinoma In Situ: Insights from a Large Neoadjuvant Endocrine Therapy Cohort. Cancer Res Commun. 2022 12; 2(12):1579-1589.
Cristian K. Maldonado Rodas, Heather Greenwood, Rita Freimanis, Alexander D. Borowsky, Gillian Hirst, Nola Hylton, Laura Esserman, Amrita Basu. Abstract B015: MRI features can identify DCIS patients who can be managed with endocrine therapy alone. Cancer Prevention Research. 2022 Dec 1; 15(12_Supplement_1):b015-b015.
Kevin L. Lu, Ryan Sieberg, Rita I. Freimanis, Heather I. Greenwood, Christopher J. Schwartz. Alveolar soft part sarcoma of the pectoralis mimicking a breast mass: A case report. Human Pathology Reports. 2022 Sep 1; 29:300674.
Natsuko Onishi, David C Newitt, Jessica E Gibbs, Alex A Nguyen, Rita Freimanis, Elissa R Price, Shelly Hwang, Nola M Hylton. Abstract P3-03-08: Background parenchymal enhancement as an imaging biomarker in neoadjuvant endocrine therapy for DCIS. Cancer Research. 2022 Feb 15; 82(4_Supplement):p3-03-08-p3-03-08.
Taliaferro AS, Price ER, Hayward JH, Wong JM, Balassanian R, Fay JS, Freimanis RI, Joe BN, Lee AY. Utility and Outcomes of Preoperative Screening Breast MRI for Planned Bilateral Prophylactic Mastectomy in High-Risk Patients. AJR Am J Roentgenol. 2022 02; 218(2):241-248.
Heather Greenwood, Rita Freimanis, Case Brabham, Rita Mukhtar, Gillian Hirst, Paul Kim, April Liang, Laura Esserman, Nola Hylton, Amrita Basu. Abstract PD5-01: Magnetic resonance imaging insights from an active surveillance cohort of women with DCIS. Cancer Research. 2021 Feb 15; 81(4_Supplement):pd5-01-pd5-01.
Case Brabham, Rita Mukhtar, April Liang, Paul Kim, Gillian Hirst, Amrita Basu, Heather Greenwood, Rita Freimanis, Alexander Borowsky, Shelley Hwang, Rick Baehner, Gregor Krings, Nola Hylton, Laura Esserman. Abstract PS1-03: Active surveillance for DCIS: Clinical outcomes at 5.6 years mean follow-up. Cancer Research. 2021 Feb 15; 81(4_Supplement):ps1-03-ps1-03.
Greenwood HI, Freimanis RI. Commentary on "Comparison of Abbreviated Breast MRI vs Digital Breast Tomosynthesis for Breast Cancer Detection Among Women With Dense Breasts Undergoing Screening". AJR Am J Roentgenol. 2021 01; 216(1):37.
Vyas S, Greenwood HI, Jankowski T, Freimanis RI, Kallianos KG, Henry TS, Strachowski LM. A case of acute onset gigantomastia in a 20-year-old woman. Clin Imaging. 2020 Dec; 68:57-60.
Jones EF, Hathi DK, Freimanis R, Mukhtar RA, Chien AJ, Esserman LJ, Van't Veer LJ, Joe BN, Hylton NM. Current Landscape of Breast Cancer Imaging and Potential Quantitative Imaging Markers of Response in ER-Positive Breast Cancers Treated with Neoadjuvant Therapy. Cancers (Basel). 2020 Jun 09; 12(6).
Paul Kim, Heather I. Greenwood, Rita I. Freimanis, Gillian L Hirst, Megan Fischer-Colbrie, Jessica Gibbs, Nola M Hylton, Christina Yau, Eun-Sil Shelley Hwang, Laura J. Esserman, Rita A Mukhtar. Abstract P6-16-06: Improved early stratification of invasive cancer risk using MRI in a ductal carcinoma in-situ short-term active surveillance cohort treated with neoadjuvant endocrine therapy. Cancer Research. 2020 Feb 15; 80(4_Supplement):p6-16-06-p6-16-06.
Lai YC, Ray KM, Lee AY, Hayward JH, Freimanis RI, Lobach IV, Joe BN. Microcalcifications Detected at Screening Mammography: Synthetic Mammography and Digital Breast Tomosynthesis versus Digital Mammography. Radiology. 2018 12; 289(3):630-638.
Ray KM, Joe BN, Freimanis RI, Sickles EA, Hendrick RE. Screening Mammography in Women 40-49 Years Old: Current Evidence. AJR Am J Roentgenol. 2018 Feb; 210(2):264-270.
Greenwood HI, Lee AY, Lobach IV, Carpentier BM, Freimanis RI, Strachowski LM. Clustered Microcysts on Breast Ultrasound: What Is an Appropriate Management Recommendation? AJR Am J Roentgenol. 2017 Dec; 209(6):W395-W399.
Greenwood HI, Freimanis RI, Carpentier BM, Joe BN. Clinical Breast Magnetic Resonance Imaging: Technique, Indications, and Future Applications. Semin Ultrasound CT MR. 2018 Feb; 39(1):45-59.
Foo ET, Lee AY, Ray KM, Woodard GA, Freimanis RI, Joe BN. Value of diagnostic imaging for the symptomatic male breast: Can we avoid unnecessary biopsies? Clin Imaging. 2017 Sep - Oct; 45:86-91.
Freimanis RI, Yacobozzi M. Breast cancer screening. N C Med J. 2014 Mar-Apr; 75(2):117-20.
Venetta Thomas, Zhi Liu, Sathish K. Srinivasan, Ren-Hua Chung, Eden Martin, Edward A. Levine, Rita I. Freimanis, Jennifer J. Hu. Abstract 2613: Racial/Ethnic specific polygenic models of breast cancer risk. Epidemiology. 2012 Apr 15; 2613-2613.
Smith TR, Levine EA, Freimanis RI, Akman SA, Allen GO, Hoang KN, Liu-Mares W, Hu JJ. Polygenic model of DNA repair genetic polymorphisms in human breast cancer risk. Carcinogenesis. 2008 Nov; 29(11):2132-8.
Van Emburgh BO, Hu JJ, Levine EA, Mosley LJ, Perrier ND, Freimanis RI, Allen GO, Rubin P, Sherrill GB, Shaw CS, Carey LA, Sawyer LR, Miller MS. Polymorphisms in CYP1B1, GSTM1, GSTT1 and GSTP1, and susceptibility to breast cancer. Oncol Rep. 2008 May; 19(5):1311-21.
Cole EB, Pisano ED, Zeng D, Muller K, Aylward SR, Park S, Kuzmiak C, Koomen M, Pavic D, Walsh R, Baker J, Gimenez EI, Freimanis R. The effects of gray scale image processing on digital mammography interpretation performance. Acad Radiol. 2005 May; 12(5):585-95.
Sharp PC, Michielutte R, Spangler JG, Cunningham L, Freimanis R. Primary care providers' concerns and recommendations regarding mammography screening for older women. J Cancer Educ. 2005; 20(1):34-8.
Smith TR, Levine EA, Perrier ND, Miller MS, Freimanis RI, Lohman K, Case LD, Xu J, Mohrenweiser HW, Hu JJ. DNA-repair genetic polymorphisms and breast cancer risk. Cancer Epidemiol Biomarkers Prev. 2003 Nov; 12(11 Pt 1):1200-4.
Zhao L, Freimanis R, Bergman S, Shen P, Perrier ND, Lesko N, Pulaski T, Pulaski S, Carr JJ, Levine EA. Biopsy needle technique and the accuracy of diagnosis of atypical ductal hyperplasia for mammographic abnormalities. Am Surg. 2003 Sep; 69(9):757-62; discussion 762.
Adler LP, Weinberg IN, Bradbury MS, Levine EA, Lesko NM, Geisinger KR, Berg WA, Freimanis RI. Method for combined FDG-PET and radiographic imaging of primary breast cancers. Breast J. 2003 May-Jun; 9(3):163-6.
Sharp PC, Michielutte R, Freimanis R, Cunningham L, Spangler J, Burnette V. Reported pain following mammography screening. Arch Intern Med. 2003 Apr 14; 163(7):833-6.
Cole EB, Pisano ED, Kistner EO, Muller KE, Brown ME, Feig SA, Jong RA, Maidment AD, Staiger MJ, Kuzmiak CM, Freimanis RI, Lesko N, Rosen EL, Walsh R, Williford M, Braeuning MP. Diagnostic accuracy of digital mammography in patients with dense breasts who underwent problem-solving mammography: effects of image processing and lesion type. Radiology. 2003 Jan; 226(1):153-60.
Levine EA, Freimanis RI, Perrier ND, Morton K, Lesko NM, Bergman S, Geisinger KR, Williams RC, Sharpe C, Zavarzin V, Weinberg IN, Stepanov PY, Beylin D, Lauckner K, Doss M, Lovelace J, Adler LP. Positron emission mammography: initial clinical results. Ann Surg Oncol. 2003 Jan-Feb; 10(1):86-91.
I.N. Weinberg, V. Zawarzin, L.P. Adler, R. Pani, G. DeVincentis, I. Khalkhali, H. Vargas, R. Venegas, S.C. Kim, G. Bakale, E. Levine, N. Perrier, R.I. Freimanis, N.M. Lesko, D.P. Newman, K.R. Geisinger, W.A. Berg, S. Masood. Requirements for effective functional breast imaging. Nuclear Instruments and Methods in Physics Research Section A Accelerators Spectrometers Detectors and Associated Equipment. 2003 Jan 1; 497(1):98-104.
Pisano ED, Cole EB, Kistner EO, Muller KE, Hemminger BM, Brown ML, Johnston RE, Kuzmiak CM, Braeuning MP, Freimanis RI, Soo MS, Baker JA, Walsh R. Interpretation of digital mammograms: comparison of speed and accuracy of soft-copy versus printed-film display. Radiology. 2002 May; 223(2):483-8.
Rita I. Freimanis, Nadine M. Lesko. The Breast Cancers We Miss. Contemporary Diagnostic Radiology. 2001 Apr 1; 24(8):1-9.
Carr JJ, Hemler PF, Halford PW, Freimanis RI, Choplin RH, Chen MY. Stereotactic localization of breast lesions: how it works and methods to improve accuracy. Radiographics. 2001 Mar-Apr; 21(2):463-73.
Webber RL, Underhill HR, Freimanis RI. A controlled evaluation of tuned-aperture computed tomography applied to digital spot mammography. J Digit Imaging. 2000 May; 13(2):90-7.
H.D. Cheng, J.R. Chen, R.I. Freimanis, X.H. Jiang. A novel fuzzy logic approach to microcalcification detection. Information Sciences. 1998 Nov 1; 111(1-4):189-205.
Cheng HD, Lui YM, Freimanis RI. A novel approach to microcalcification detection using fuzzy logic technique. IEEE Trans Med Imaging. 1998 Jun; 17(3):442-50.
Thomason JW, Ely EW, Chiles C, Ferretti G, Freimanis RI, Haponik EF. Appraising pulmonary edema using supine chest roentgenograms in ventilated patients. Am J Respir Crit Care Med. 1998 May; 157(5 Pt 1):1600-8.
J. Jeffrey Carr, Paul F. Hemler, Rita I. Freimanis, Robert H. Choplin, Price W. Halford. Stereotactic localization of breast lesions: How it works and methods for improving accuracy. Academic Radiology. 1997 Dec 1; 4(12):862-863.
Ely EW, Johnson MM, Chiles C, Rushing JT, Bowton DL, Freimanis RI, Choplin RH, Haponik EF. Chest X-ray changes in air space disease are associated with parameters of mechanical ventilation in ICU patients. Am J Respir Crit Care Med. 1996 Nov; 154(5):1543-50.
Murphy JS, Freimanis RI, Harmon BH. Abdominal mass in a four-year-old boy. Invest Radiol. 1990 Sep; 25(9):1058-60.
Freimanis R, Zoghbi SS, Gottschalk A. The effect of 'irrelevant' IgG protein selection on target uptake ratios of radiolabeled antibodies. Invest Radiol. 1988 Jul; 23(7):537-9.