46-year-old woman called back for bilateral breast masses on screening mammogram. An ML view and two spot compression views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density(BiRads Density Category B), unchanged in pattern and distribution. There are partially circumscribed masses in the lateral right breast near 9:00 position, central right breast near the 12:00 position and lateral left breast near the 2-o'clock position which which all persist on additional views. An ultrasound will be performed for further evaluation. Additional upper inner left breast mass also again seen, previously noted to be stable. No suspicious microcalcifications or areas of architectural distortion in either breast. BILATERAL BREAST ULTRASOUND:On physical exam, there is no palpable or visible abnormality of either breast.Targeted grayscale and color Doppler ultrasound right breast was performed for the mammographic areas of concern. Corresponding to the well-circumscribed mass seen in the lateral right breast is a 9 mm cluster of cysts with punctate echogenic foci likely representing milk of calcium at the 9:00 position 5 cm from nipple. The largest cyst within this cluster measures approximately 5 x 3 mm. Corresponding to the well-circumscribed mass seen in the central right breast on mammogram is a cluster of complex cysts at the 12:00 position 2 cm from nipple, with the largest cyst within this cluster measuring 7 x 7 mm. No internal vascularity or nodularity is appreciated in either location.Targeted grayscale and color Doppler ultrasound of left breast was performed for the mammographic area of concern. Correlating to the left upper outer quadrant mass seen on mammogram is a 5 x 6 x 5 mm cyst at the 2:00 position 5 cm from nipple. No internal vascularity or nodularity. Note that these findings correlate well to an MRI that was recently submitted showing multiple bilateral cysts.
Bilateral breast cysts. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram.