A patient submitted outside study for review. Submitted for review are digital mammographic images (5/27/2015), images from stereotactic core needle biopsy of right breast and postprocedural right mammographic images (5/27/2015), breast MRI (6/6/15) performed at Northwestern Memorial Hospital. DIGITAL MAMMOGRAPHIC IMAGES (5/27/2015):The breast parenchyma is heterogeneously dense. There are two clusters of suspicious pleomorphic calcifications in the right breast. One is located at posterior 12:00 position, measuring 8 mm. The other is located at superior and far lateral aspect of the right breast. Those calcifications are linearly arranged, measuring 12 mm.No dominant mass, suspicious microcalcifications or areas of architectural distortion are noted in left breast. IMAGES FROM STEREOTACTIC CORE NEEDLE BIOPSY OF RIGHT BREAST AND POSTPROCEDURAL RIGHT MAMMOGRAPHIC IMAGES (5/27/2015):Stereotactic core biopsy was performed for 2 sites of calcifications in the right breast. According to outside report, the calcifications at 12:00 was sampled by superior approach, and the calcifications at upper outer aspect was sampled by inferior approach. No specimen radiograph is submitted. Postprocedural right mammographic images show a dumbbell shaped clip at 12:00 position, 12 mm inferior to the biopsy site, and a x shaped clip at the biopsy site of far lateral superior aspect. No residual calcifications are identified at either site. Per outside radiology report, pathology for 12:00 lesion was DCIS grade 1-2 with ADH, and for far lateral superior site was focal ADH with benign findings.BREAST MRI (6/6/15): Imaging protocol is described in the outside radiology report.There is heterogeneous amount of fibroglandular tissue in both breasts.Marked parenchymal enhancement is noted bilaterally, limiting the sensitivity of MRI.There are two clip artifacts in the right breast, at posterior 12:00 position and the posterior upper outer aspect. Within the limitations due to marked parenchymal enhancement, no suspicious enhancement superior to the 12:00 clip or around the upper outer clip is seen. No abnormal enhancement is seen in left breast. No abnormal lymph nodes are identified in either axillary region.
Biopsy proven DCIS in the right posterior 12:00 and focal ADH at far lateral superior right breast. Marker clip was displaced 12 mm inferiorly at 12:00 lesion, and the clip at the upper outer lesion was located at the biopsy site. MRI did not show suspicious enhancement. Pathology slides should be reviewed at University of Chicago. BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.