A patient submitted outside study for review. Submitted for review are ultrasound dated 7/6/2015 and post procedure mammogram dated 7/6/2015 performed at St. Mary Medical Center. For comparison,MRI dated 7/1/2015, mammogram dated 6/26/2015, ultrasound dated 6/24/2015 and priors are available. This is a continuation of prior submitted outside studies for which interpretation was already performed (Accession number 15188354). A followup right breast ultrasound was performed based on outside interpretation of MRI.Ultrasound: A targeted right breast ultrasound was performed in the areas of questionable abnormal enhancement seen on prior MRI.1. 6:00 position 1 cm from the nipple - oval, circumscribed, hypoechoic mass measuring 7 x 3 x 4 mm.2. 5:00 position 0.5 cm from the nipple - round, hypoechoic circumscribed mass measures 3 x 4 x 6 mm.3. Right breast 7:00 position 1 cm from the nipple - subtle, indistinct, hypoechoic mass measuring 4 x 7 x 6 mm.The aforementioned lesions were targeted and biopsied with a 12 gauge biopsy gun. 3 cores were obtained from each target. Clips were then placed.Postprocedure mammogram: 3 standard views of the right breast were obtained post biopsy. 3 biopsy clips are noted in the retroareolar region.
1. Ultrasound guided right breast biopsies as above. Postprocedure mammogram demonstrates 3 retroareolar clips. Biopsy results as follows:Right breast 7:00 biopsy: Benign breast tissue with marked fibrosis and mild cystic dilatation of the ducts.Right breast 6:00 biopsy: Benign breast tissue with marked fibrosis with focal fat necrosis.Right breast 5:00 biopsy: Benign breast tissue with fibrocystic changes.These results are concordant with imaging findings. The biopsies can be submitted to University of Chicago for official interpretation if clinically warranted.2. Multifocal left breast mass with inferior extension as seen on mammogram and MRI with total extent of 29 x 15 mm. This mass has been biopsy proven to represent ILC grade 2.3. Clip not seen on post procedure mammogram. Clip placement recommended at the University of ChicagoBIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.