Ms. Bergiel is a 34 year old female with a personal history of known right breast cancer presenting for assessment of tumor response. Family history includes mother, maternal grandmother, and maternal great grandmother diagnosed breast cancer. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. 3 additional spot compression views and one exaggerated CC view of the right breast were obtained. Targeted grayscale and color ultrasound was subsequently performed.MAMMOGRAM:The breast parenchyma is heterogeneously dense, which may obscure small masses (BiRads Density Category C), unchanged in pattern and distribution. Benign-appearing calcification in the retroareolar space is unchanged.4 biopsy clips are visualized in the lower, inner right breast. One placed at the time of MRI biopsy in the anterior depth, 2 clustered hydromark biopsy clips within one of the masses that were biopsied at University of Chicago, and a wing clip placed within the adjacent mass placed at outside hospital. The 2 hydromark clips from the University of Chicago performed biopsy appear superomedial in comparison to the wing clip. There are calcifications present between the clips.ULTRASOUND:2 biopsy clips are visualized within the University of Chicago performed biopsy in the superomedial lesion. Just inferolateral to this lesion is a possible biopsy clip with adjacent hypoechoic lesion measuring 0.8 x 0.3 x 0.5 cm, previously 1.0 x 0.8 x 1.0. Punctate calcifications are visualized between these clip locations. The wing clip is difficult to identify.
Near complete response of masses within the right inner, medial breast. Results and recommendations were discussed with the patient.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.