A patient submitted outside study for review. Submitted for review are specimen radiograph of left breast and post-procedural left digital mammographic images (2/20/15), digital mammographic images (1/29/15), ultrasound images of both breasts (1/29/15, 11/10/14) and breast MRI (10/8/14) performed at Rush University Medical Center. For comparison, digital mammographic images (1/22/13, 1/22/14) are available. BREAST MRI (10/8/14):The study was performed with a protocol outlined in the outside radiology report. The study was performed for screening purposes. There is extreme amount of fibroglandular tissue in both breasts.Moderate parenchymal enhancement is noted bilaterally.There is a focal non mass enhancement in the left breast at 12 o'clock position, measuring 8 x 6 x 7 mm (AP x LR x CC).In the right breast, there are scattered enhancing foci are seen , but no abnormal enhancement is present.ULTRASOUND IMAGES OF BOTH BREASTS (11/10/14):This study was performed for second look ultrasound of non specific focus in the right breast at 10 o'clock position and an enhancing lesion in the left breast at 12 o'clock position seen on MRI. In our interpretation, the focus in the right breast is a part of parenchymal enhancement, which is benign. On ultrasound, no sonographic correlates are detected in either breast.DIGITAL MAMMOGRAPHIC IMAGES (1/29/15):The breast parenchyma is extremely dense, unchanged in pattern and distribution. A cluster of amorphus calcifications, measuring 5 mm, is present at 12 o'clock position in the left breast. This cluster of calcifications likely corresponds to the non mass enhancement seen on MRI.No dominant mass, suspicious microcalcifications or areas of architectural distortion are noted in right breast. ULTRASOUND IMAGES OF BOTH BREASTS (1/29/15):Normal appearing lymph node is present in the right axilla. No abnormal findings are visualized in the provided sonographic images.SPECIMEN RADIOGRAPH OF LEFT BREAST AND POST-PROCEDURAL LEFT DIGITAL MAMMOGRAPHIC IMAGES (2/20/15):Per outside radiology report, patient underwent stereotactic biopsy for left breast calcifications.Specimen radiographs reveal target calcifications within some specimens.A marker clip is present at the site of the cluster of calcifications (12 o'clock) in the left breast on post-procedural left digital mammographic images. No residual calcifications are seen.Per outside pathology report, the biopsy result was malignant, DCIS grade 2.
Biopsy proven DCIS in the left breast. Breast MRI demonstrates unifocal lesion in the left breast at 12 o'clock position.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.