30 year-old history of bilateral breast implants who sustained a work-related injury 2 weeks ago presents for further evaluation and follow-up to breast MRI. MAMMOGRAM: Three standard and implant displaced views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density(BiRads Density Category B), unchanged in pattern and distribution. The collapsed right retropectoral implant is similar in appearance to the MRI. A left retropectoral implant is intact with contours maintained.No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. Benign appearing lymph nodes are projected over both axillae.LEFT AXILLA ULTRASOUND:On physical exam, there is no visible abnormality of the left breast.A targeted left axillary grayscale and color Doppler ultrasound was performed enlarged left axilla lymph nodes identified on MRI 12/24/2015. Two lymph nodes are identified deep in the left axilla. The largest lymph node measures 1.6 x 0.5 cm. Both lymph nodes demonstrate normal morphology with hilar flow.
Bilateral breast implants with collapse of the right implant similar to the findings on MRI. No sonographic or mammographic evidence of malignancy. Normal morphology lymph nodes in the left axilla. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually starting at age 40. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram.