32 year old with history of left breast cancer on neoadjuvant chemotherapy. Extensive suspicious calcifications in the left breast. On recent MRI, asymmetry in the right inferior breast was also identified, and further evaluation was recommended. LEFT BREAST:A targeted left ultrasound was performed patient's known left upper outer quadrant cancer. In the upper outer quadrant at the 1:00 position 3 cm from nipple there is a hypoechoic mass with biopsy clip seen centrally measuring approximately 7 x 3 x 12 mm (CC x AP x LR), consistent with biopsy-proven cancer. This mass measured up to 3 cm per report from outside hospital. There is an elongated geographic mixed echogenicity area with echogenic calcifications extending from the mass along the 1:00 radian. The mass and the adjacent strip measures approximately 18 mm long, and is 6 mm thick. There is an adjacent parallel elongated hypoechoic, geographic area with calcification at the 1:00-2:00 position approximately 4 cm from nipple, inferior and lateral to the biopsy proven cancer which measures approximately 12 x 2 x 11 mm (CC by AP by TV). These likely correlate to areas of non-mass enhancement seen on recent MRI.Targeted ultrasound of the left breast outer lower quadrant from 3:00 to 6:00 was also performed. No abnormalities are identified.RIGHT BREAST:A targeted right ultrasound was performed for the area of concern in the right inferior breast identified on MRI breast 6/1/2015 spanning 3:00 through 9:00 positions. Unremarkable sonographically dense fibroglandular tissue is present throughout the inferior breast. No discrete solid or cystic masses are identified. No correlates to the MRI findings are seen.
Interval decrease in size of known left breast cancer measuring 7 x 3 x 12 mm, previously measured up to 3 cm. Adjacent mixed echogenicity areas with calcifications are noted as described and likely correlate to areas of non-mass enhancement seen on recent MRI.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.