A patient submitted outside study for review. Submitted for review are digital mammographic images (4/27/15, 3/21/14, 3/10/14), ultrasound images (4/27/15, 3/21/14, 3/20/14, 3/10/14), breast MRI (3/17/14) performed at St. Mary's Medical Center. DIGITAL BILATERAL MAMMOGRAPHIC IMAGES AND ULTRASOUND IMAGES OF RIGHT BREAST (3/10/14):The breast parenchyma is composed of scattered fibroglandular elements. There is an oval mass measuring approximately 15 mm at posterior upper inner quadrant in the right breast. A marker clip is identified approximately 2 cm superior to this mass. Benign-appearing calcifications are present immediately posterior to this mass.In the left breast, there is a circumscribed oval mass measuring 7 mm at posterior upper inner quadrant, with adjacent marker clip. This mass is presumably biopsied. No suspicious microcalcifications or areas of architectural distortion are noted in either breast. Ultrasound of the right breast failed to detect any sonographic correlate to the right breast mass on the mammogram.BREAST MRI (3/17/14):Imaging protocol is described in the outside radiology report.There is scattered fibroglandular tissue in both breasts.Mild parenchymal enhancement is noted bilaterally.There is a lobulated mass measuring 17 x 10 x 15 mm (AP x LR x CC) at posterior 2:00 position in the right breast. This enhancing mass corresponds to the mass seen on the prior mammogram. An 8 mm circumscribed, oval mass is present at central aspect in the left breast. Another small circumscribed mass measuring 6 mm is seen at posterior 11:00 position in the left breast, corresponding to the small mass seen on the prior mammogram. This is presumably a benign lesion.No abnormal axillary lymph nodes are identified in either axillary region.ULTRASOUND IMAGES (3/20/14):This is an MR directed ultrasound study for right and left breast. In the right breast, there is a 15 mm lobulated mass at 2:00 position, corresponding to the MR findings. In the left breast, there is a 10 mm oval mass at 12:00 position, corresponding to the mass seen on the MRI at central aspect in the left breast. The left breast mass appears benign.IMAGES FROM ULTRASOUND-GUIDED BIOPSY OF RIGHT BREAST AND POSTPROCEDURAL RIGHT MAMMOGRAPHIC IMAGES (3/21/2014):Ultrasound guided biopsy with clip placement was performed for the right breast mass at 2:00 position. Postprocedural mammographic images show a marker clip at the superior-anterior peripheral aspect of the lesion. Biopsy result was fibroadenoma.DIGITAL BILATERAL MAMMOGRAPHIC IMAGES AND ULTRASOUND IMAGES OF RIGHT BREAST (4/27/15):The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution.A proven fibroadenoma is again seen in the right breast at posterior upper inner quadrant with a marker clip. In the left breast at central aspect, there is a circumscribed mass measuring 8 mm. This mass likely corresponds to the enhancing mass seen on MRI.Ultrasound study for left breast detected a correlating mass, measuring 9 x 4 mm at 1:00 position. This is the same mass detected on the ultrasound study of 3/20/14. There are no interval changes.
No mammographic evidence of malignancy. The patient is reportedly high risk for breast cancer. Annual MRI screening is recommended.BIRADS: 2 - Benign finding.RECOMMENDATION: X - No Letter.