A patient submitted outside study for review. Submitted for review are breast MRI (2/5/2016), ultrasound images of both breasts with images from left breast biopsy and postprocedural left mammographic images (2/10/2016) performed at Loyola University. For comparison, breast MRI (1/21/15, 12/26/13), ultrasound images (6/19/15), digital mammographic images (6/19/15, 7/24/13) are available. BREAST MRI (2/5/2016):Breast MRI was performed with a protocol outlined in the outside radiology report.There are multiple cysts in both breasts.Susceptibility artifact from a marker clip is present at anterior medial lower left breast.There is a new enhancing mass measuring 8 mm at posterior lower outer quadrant in the left breast.There are multiple enhancing foci, likely parenchymal enhancement, unchanged in comparison to the prior studies.There is no new findings in the right breast.ULTRASOUND IMAGES OF BOTH BREASTS WITH IMAGES FROM LEFT BREAST BIOPSY AND POSTPROCEDURAL LEFT MAMMOGRAPHIC IMAGES (2/10/2016):There are multiple simple and complicated cysts in both breasts. No suspicious masses are seen in the right breast. In the left breast, there is a hypoechoic oval mass with increased blood flow at 4:00 position, 8 cm from the nipple. This mass might corresponds to the new enhancing mass seen in the posterior lower outer quadrant on MRI.A needle biopsy was performed for the mass at 4:00 position, 8 cm from the nipple in the left breast, with appropriate needle placement. Per pathology report, the result was benign, unremarkable breast parenchyma, with comment "features of the mass forming lesion are not identified."Postprocedural left mammographic images show a marker clip from this biopsy placed at lower outer quadrant in the left breast. Another marker clip is identified at lower inner quadrant in the left breast.
New enhancing mass at posterior lower outer quadrant in the left breast, with sonographic correlate. A biopsy result was benign, however no mass forming lesion was identified on pathology. Therefore short-term MRI follow-up in 6 months is recommended.BIRADS: 2 - Benign finding.RECOMMENDATION: X - No Letter.