Ms. Lyons is a 47 year old female presenting for MR-directed ultrasound based on outside hospital MRI findings. Targeted left breast ultrasound was performed for the outside hospital MRI findings, including 8.4 cm of diffuse nonmass enhancement in the left outer breast. No sonographic correlate was identified for the MRI findings.Targeted left axillary ultrasound was performed for the outside hospital MRI findings. In the left axilla, there is an abnormal morphology lymph node identified measuring 2.5 x 1.1 x 2.1 cm.
(1) No sonographic correlate identified for the 8.4 cm diffuse nonmass enhancement in the left outer breast. Therefore, a two-site MR guided biopsy is recommended for further evaluation.(2) Abnormal morphology lymph node in the left axilla. An ultrasound-guided biopsy with clip placement is recommended for further evaluation.All results and recommendations were discussed with the patient.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration.