A patient submitted outside study for review. Submitted for review are ultrasound images of right breast and right axilla (12/12/14), Images from ultrasound guided biopsy of right breast (12/30/14) and breast MRI (1/9/15) performed at St Anthony Crown Point. ULTRASOUND IMAGES OF RIGHT BREAST AND RIGHT AXILLA (12/12/14):A round, microlobulated mass, measuring 7 x 5 mm, is visualized at right breast at 10 o'clock position.In the right axilla, one lymph node has 5 x 4 mm focal hypoechoic round mass, suggesting metastatic deposit of the lymph node. In addition, a few normal appearing lymph nodes are visualized.IMAGES FROM ULTRASOUND GUIDED BIOPSY OF RIGHT BREAST (12/30/14):Ultrasound guided vacuum assisted core biopsy was performed for the right breast mass with appropriate needle placement. Per outside radiology report, a marker clip was placed to the biopsy site. The result was malignant.BREAST MRI (1/9/15):The study was performed with a protocol outlined in the outside radiology report. Images could not be processed with our DynaCAD workstation. Because the images cannot be reviewed on the dedicated MRI workstation, limited interpretation is made. A biopsy cavity, measuring 19 x 14 mm (AP x LR) on axial view, is present at upper outer quadrant with rim enhancement. A marker clip is identified in the central portion of this biopsy cavity. Rim enhancement of this cavity is likely due to post biopsy changes. Volume of the remaining tumor cannot be assessed due to the biopsy changes. Mild enhancement is seen around the biopsy cavity, likely due to post biopsy changes.No abnormal enhancing lesions are seen in the left breast.There are no abnormal lymph nodes in either axilla on these limited low resolution MRI.
Status post vacuum assisted biopsy of the right breast cancer. Enhancement seen on the MRI was mostly due to post biopsy changes (interpretation of MRI was limited due to inability of reviewing images on the dedicated MRI workstation). Ultrasound of the right axilla showed possible metastatic deposit within one of the lymph nodes.Mammogram has not been submitted for review. Mammogram will be useful for evaluation of both breasts, and post-biopsy changes of right breast.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.