The patient submitted outside screening mammogram dated 5/10/2014, diagnostic left mammogram and ultrasound dated 5/16/2014, from Silver Cross Hospital. Additionally, images from an MRI guided left breast biopsy and post-procedural mammogram were submitted. MAMMOGRAM AND ULTRASOUND (5/10/2014 and 5/16/2014): Submitted outside study was compared to the current, post-neoadjuvant chemotherapy, mammogram dated 1/28/2015. There has been decrease in size of the irregular asymmetry within the upper outer left breast which now measures 8.0 x 4.9 x 2.6 cm (previously 9.4 x 6.0 x 3.4 cm). Comparison with prior ultrasound is more difficult given differences in measurement techniques. The multiple masses within the left upper outer breast appears slightly smaller on recent ultrasound examination.A 0.4 cm cluster of calcifications is present within the right upper outer breast, without significant change. No dominant mass is present in the right breast. IMAGES FROM MRI GUIDED RIGHT BREAST BIOPSY and POST PROCEDURAL MAMMOGRAM (6/20/2014): Images from MRI guided biopsy of the 0.4 cm enhancing focus at the 11:00 position of the right breast were submitted. Targeting appears appropriate. A clip was placed following biopsy. Post procedural CC and ML views of the right breast demonstrate a clip at the biopsy site. A moderate hematoma is present. PATHOLOGY: Per outside report, pathology from the MRI guided right breast biopsy demonstrated invasive ductal carcinoma, grade 2.
1. There has been decrease in size of the conglomerate of masses in the left breast following neo-adjuvant chemotherapy. Post treatment measurement is 8.0 x 4.9 x 2.6 cm (previously 9.4 x 6.0 x 3.4 cm. 2. Successful MRI guided biopsy of enhancing focus at the 11 o'clock position of the right breast demonstrating invasive ductal carcinoma.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.