64-year-old female with bloody discharge from the left nipple. Examinations performed at an Christ hospital were submitted for interpretation. BILATERAL MAMMOGRAM (4/4/2016): 2 standard views of both breasts with repeat left MLO were submitted for review. The breast parenchyma is heterogeneously dense, which may obscure small masses (BiRads Density Category C). Note is made of multiple bilateral subcentimeter masses for which long term stability should be confirmed. There is a focal asymmetry in the upper outer quadrant of the right breast, at posterior depth, which should also be evaluated for stability and can be further evaluated on MRI if that is performed for her nipple discharge. Note is made of bilateral benign morphology calcifications, including arterial calcifications. The left nipple appears inverted. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. TARGETED BILATERAL BREAST ULTRASOUND EXAMINATION (4/4/2016):Right Breast:Targeted right breast ultrasound examination demonstrates no focal mass lesion or cyst at images labeled at 9:00 to 11:00.Left Breast:Targeted ultrasound examination demonstrates ectatic ducts in the retroareolar region of the left breast. No focal mass lesion or cyst is identified.
1. Ectatic ducts in the retroareolar region of the left breast. Otherwise no findings to account for the patient's left sided bloody nipple discharge. Surgical consultation and consideration of further imaging with MRI are recommended for further evaluation.2. Multiple bilateral subcentimeter masses for which long-term stability should be confirmed. While multiplicity suggests benignity, submission of prior examinations for comparison is recommended. 3. Focal asymmetry in the upper outer quadrant of the right breast with a negative ultrasound. Comparison study submission would be helpful for this area as well, and it can also be further evaluated on MRI if that is performed for her nipple discharge.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: T - Take Appropriate Action - No Letter.