Patient submitted outside studies for review. Submitted for review are:-bilateral diagnostic mammogram (02/17/2016)-bilateral breast ultrasound (02/17/2016) -US guided biopsy of left breast with postprocedural left mammographic images (02/22/2016)-bilateral breast MRI (03/03/2016) performed at Adventist Hinsdale Hospital.-Images from ultrasound-guided biopsy of the right breast (03/29/2016)-Specimen radiograph of stereotactic biopsy of left breast (03/29/2016)-MR guided biopsy of right breast (03/29/2016)-Postprocedural mammogram of both breasts (03/29/2016)performed at Rush University Medical Center. BILATERAL DIAGNOSTIC MAMMOGRAM (02/17/2016):The breast parenchyma is heterogeneously dense (BiRADS Density Category C). A triangular marker is placed at posterior upper outer quadrant of left breast, denoting the area of palpable lump.Ill-defined focal asymmetry is seen at upper outer quadrant in the left breast, at the site of palpable marker. There is a small cluster of amorphous calcifications at upper inner quadrant in the left breast.No dominant mass, suspicious microcalcifications or areas of architectural distortion are noted in right breast. BILATERAL BREAST ULTRASOUND (02/17/2016):There is an ill-defined hypoechoic mass measuring 13 x 10 mm at 2:00 position in the left breast, corresponding to the area of palpable lump. In the left axilla there is one normal appearing lymph node. In the right breast at 4:00 position, there is an anechoic 5 x 3 mm simple cyst.US GUIDED BIOPSY OF LEFT BREAST WITH POSTPROCEDURAL LEFT MAMMOGRAPHIC IMAGES (02/22/2016):Ultrasound guided biopsy of the left breast mass at 2:00 position is performed with appropriate needle placement. Postprocedural mammographic images demonstrate a marker clip at posterior aspect of the focal asymmetry in the left upper outer quadrant.Per outside report, the pathology result was malignant; invasive ductal carcinoma grade 2.BILATERAL BREAST MRI (03/03/2016):Breast MRI was performed with a protocol outlined in the outside radiology report.There is heterogeneous amount of fibroglandular tissue in both breasts.Moderate parenchymal enhancement is noted bilaterally.In the left posterior 2:00 position, there is an enhancing mass, measuring 16 x 16 x 22 mm (AP x LR x CC), with susceptibility artifact from a marker clip. This is the proven IDC. There is an enhancing focus anterior to the index mass, suspicious for satellite lesion. Overall AP distance of index mass and focus is 31 mm.In the right breast at 12:00 position, there is an indeterminate enhancing mass, measuring 8 x 6 x 7 mm.No abnormal lymph nodes are identified in either axillary region.IMAGES FROM ULTRASOUND-GUIDED BIOPSY OF THE RIGHT BREAST (03/29/2016):Ultrasound guided biopsy was performed for an oval mass, measuring 5 mm, at 9:00 position, 3 cm from nipple, in the right breast. Needle placement appears appropriate. Post-procedural mammographic images show a marker clip at anterior 9:00 position in the right breast. Pathology result is not available.SPECIMEN RADIOGRAPH OF STEREOTACTIC BIOPSY OF LEFT BREAST (03/29/2016):Per outside radiology report, stereotactic biopsy was performed for a cluster of calcifications in the left upper inner quadrant. Specimen radiograph demonstrates target calcifications within one of the cores. Post-procedural mammographic images show a marker clip at anterior upper inner quadrant in the left breast. Pathology result is not available. MR GUIDED BIOPSY OF RIGHT BREAST (03/29/2016):MR guided biopsy was performed for an enhancing mass in the right breast at 12:00 position. Post-biopsy MR images show biopsy changes with hematoma at the site of the enhancing mass. Post-procedural mammographic images show a marker clip at anterior 11:30 position in the right breast. Pathology result is not available.
1. Biopsy proven IDC in the left breast at posterior 2:00 position, with possible satellite located anteriorly.2. Status post US guided biopsy of right breast mass at 9:00 position, stereotactic biopsy of calcifications at upper inner quadrant in the left breast, and MR guided biopsy of right breast mass at 12:00 position. Pathology results of these biopsies are not available at the time of this dictation.3. No abnormal lymph nodes in either axillary regionBIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.