Ms. Durdle is a 50-year-old woman with history of left DCIS status post lumpectomy with positive surgical margins. Bilateral breast MRI dated 7/25/2016 performed at St. Francis Medical Center demonstrated a subcentimeter enhancing mass in the right upper outer breast as well as irregular enhancement adjacent to the left postoperative seroma. She presents today for sonographic evaluation of both findings. Targeted sonographic evaluation of the left 12:00 position 2 cm from the nipple reveals an irregular, mixed hypoechoic/anechoic structure which measures approximately 2.5 x 1.8 x 0.5 cm in size, consistent with post-surgical seroma/scar. This structure lacks internal vascularity, as demonstrated by color Doppler interrogation. No adjacent mass lesion, nodularity or other suspicious finding is sonographically evident.Targeted sonographic evaluation of the right 10:00 position 4 cm from the nipple reveals a homogeneous hypoechoic structure with increased through transmission, which measures 0.5 x 0.3 x 0.5 cm in size. This structure lacks internal vascularity, as demonstrated by color Doppler interrogation. This lesion may not correlate to the focal abnormality identified on the previous MRI.
1. Postoperative changes in the left breast without adjacent mass lesion or other suspicious abnormality. 2. A subcentimeter structure identified in the area of interest in the right breast has imaging features most compatible with a simple cyst. Because no suspicious findings are detected in the left breast around the seroma/scar, image-guided localization may not be performed.As the findings in the right breast may not correlate with the MR findings, follow-up breast MRI in 6 months is recommended.These findings and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter.