42-year-old female with pT2(m)N1a IDC of the R breast s/p mastectomy and axillary lymph node dissection (3/17 total + LNs), ER/PR+, Her-2- in 7/2013. S/p Chemo and XRT. She was on Tam but stopped after one month due intolerable hot flashes. Discussed AI/ovarain suppressio History: with pT2(m)N1a IDC of the R breast s/p mastectomy and axillary lymph node dissection (3/17 total + LNs), ER/PR+, Her-2- in 7/201 RIGHT BREAST:Again seen are postsurgical changes in the right breast which are unchanged. The retropectoral saline implant appears intact. No abnormal sized axillary lymph nodes are identified in the right axillary region.LEFT BREAST:There is unchanged heterogeneity of fibroglandular tissue in the left breast with minimal parenchymal enhancement noted. The retropectoral saline implant appears intact. The previously described enhancing focus in the 5 o'clock position near the implant is is no longer seen. However a more benign round 5 x 4 x 4 mm enhancing focus is identified in the anterior depth of the left breast in the 5:00 position adjacent to the implant which could represent fat necrosis. However this area should be followed in subsequent exams to ensure stability. There are stable prominent left-sided axillary lymph nodes.
1.The previously described enhancing focus in the 5 o'clock position near the implant is is no longer seen. However a more benign appearing round 5 x 4 x 4 mm enhancing focus is identified in the anterior depth of the left breast in the 5:00 position adjacent to the implant which could represent fat necrosis. However this area should be followed in subsequent exams to ensure stability.2.Stable post-surgical changes in the reconstructed right breast without evidence of malignancy.3.Stable slightly prominent left-sided axillary lymph nodes.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months).