Patient is a 40-year-old female with biopsy proven malignancy in the left breast, approximately 4:00 position, and the indeterminate subcentimeter left retroareolar focus approximately 11:00. Mammogram was requested to evaluated the postbiopsy clip which was placed at outside hospital. DIAGNOSTIC MAMMOGRAM OF LEFT BREAST: Three standard views of left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. A focal asymmetry is identified in the lower outer quadrant of left breast, which corresponds to the findings on the prior MRI and the mammogram. An S shaped is present in the slightly medial and inferior aspect of the focal asymmetry.DIAGNOSTIC ULTRASOUND OF THE LEFT BREAST:Left breast ultrasound was performed at the upper in her left breast where the indeterminate subcentimeter enhancement is found on the recent MRI. Ultrasound demonstrates a 4 x 3 x 4 mm hypoechoic mass at 11:00 location, 1.2 cm medial and superior to the known cancer. Incidental note is made of a 3 mm cyst adjacent to this 4 mm mass.
Indeterminate 4 mm hypoechoic mass, 1.2 cm medial to the known cancer in the left breast, for which ultrasound guided biopsy is recommended. Postbiopsy clip in the slightly medial and inferior aspect of known left breast cancer. Results and recommendation were discussed with the patient and Dr. Jaskowiak.BIRADS: 6 - Known cancer.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration.