Ms. Balling is a 61 year old female with biopsy-proven left breast cancer and clinically positive lymph nodes status post neoadjuvant chemotherapy. Upon physical exam, there is vague nodularity identified in the left upper outer breast.A targeted left breast ultrasound was performed for the patient’s area of concern. In the left breast 2:00 location, approximately 5 cm from the nipple, there is an irregular hypoechoic mass measuring 3.7 x 1.8 x 2.8 cm. The irregular mass extends towards the nipple and measures approximately 4.5 cm in the posterolateral to anteromedial direction. There is minimal associated vascularity.In the left axillary tail, an irregular hypoechoic mass is identified measuring approximately 1.6 x 0.7 x 2.9 cm. This may represent one of the enlarged axillary lymph nodes that was identified on prior MRI from 05/2015.
(1) Biopsy proven malignancy in the left breast, measuring slightly smaller when compared to prior MRI from 05/2015. (2) Abnormal soft tissue mass in the left axillary tail, which may represent an enlarged lymph node, as identified on prior MRI.An MRI may be more helpful for surgical planning/management as we would have an equivalent mode of comparison for the biopsy proven malignancy and enlarged axillary lymph nodes. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.