A patient submitted outside study for review. Submitted for review are digital mammographic images (4/15/15), ultrasound images of left breast (4/15/15), breast MRI (4/20/15) performed at Central DuPage Hospital. For comparison, digital mammographic images (10/1/13) are available. DIGITAL MAMMOGRAPHIC IMAGES (4/15/15):The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. A lobulated mass with ill-defined margins, measuring 3 cm, is present at posterior lower outer quadrant in the left breast.Dense calcification is present immediately inferior to the mass.No dominant mass, suspicious microcalcifications or areas of architectural distortion are noted in right breast. ULTRASOUND IMAGES OF LEFT BREAST (4/15/15):A lobulated mass is seen at the 5 o'clock position, measuring 29 x 21 x 26 mm, in the left breast, corresponding to the mammographic findings. A few normal-appearing lymph nodes are detected in the left axilla.BREAST MRI (4/20/15):An enhancing mass is present at middle 5:30 position in the left breast, measuring 34 x 32 x 35 mm (AP x LR x CC). This mass is located close to the skin. No suspicious findings are seen in the right breast.An enlarged lymph node (maximum diameter: 2.7-cm) is seen at left axilla.Per outside radiology report, the pathology of the left breast mass is malignant.
Unifocal malignant mass in the left breast with an enlarged left axillary lymph node. Repeat ultrasound of left axilla is recommended.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.