79 year old history of left mastectomy in 1999 now with positive contralateral (right) axillary node and supraclavicular nodes seen on CT. Recent MRI showed linear non-mass enhancement in the right upper outer breast measuring up to 3.9 cm. Patient presents for second look MRI directed ultrasound. On physical exam, there is no palpable mass.A targeted right ultrasound was performed for the area of concern seen on MRI. Targeted ultrasound of the right breast upper outer quadrant from the 9:00 through 12:00 locations was performed. There is no mass or suspicious areas seen to correspond to the findings on MRI.Incidental note is made of a dilated debris-filled duct in the periareolar region measuring 1.2 x 0.5 x 1.1 cm.
No sonographic abnormality corresponding to the MRI findings in the right upper outer breast. Recommend MRI guided biopsy of the non-mass enhancement. Findings were discussed with the patient at the time of the exam. The BI-RADS on this report reflects findings on this exam only. This does not reflect MRI findings or known malignant right axilla lymph node.BIRADS: 1 - Negative.RECOMMENDATION: T - Take Appropriate Action - No Letter.