A patient submitted outside study for review. Submitted for review are digital mammographic images (7/17/15), ultrasound images of right breast (7/17/15), images from right ultrasound guided biopsy and post-procedural right mammographic images (7/23/15), breast MRI (7/28/15) performed at Northshore University Healthsystem. DIGITAL MAMMOGRAPHIC IMAGES (7/17/15):The breast parenchyma is heterogeneously dense. A triangular marker is placed at anterior 12 o'clock position of right breast, denoting the area of palpable lump.A focal asymmetry with mild architectural distortions are present at the site of palpable lump, at 12:00 position in the right breast. There are scattered pleomorphic calcifications around the asymmetry.No dominant mass, suspicious microcalcifications or areas of architectural distortion are noted in left breast. ULTRASOUND IMAGES OF RIGHT BREAST (7/17/15):A lobulated mass with mixed hypo- and isoechoic lesion, measuring 19 x 7 mm is detected at the site of palpable lump.IMAGES FROM RIGHT ULTRASOUND GUIDED BIOPSY AND POST-PROCEDURAL RIGHT MAMMOGRAPHIC IMAGES (7/23/15):Ultrasound guided biopsy for the right breast mass was performed with appropriate needle placement. Post-procedural right mammographic images show a marker clip located at superior aspect of the abnormal asymmetry.Per outside radiology repost, the biopsy result was malignant.BREAST MRI (7/28/15):Breast MRI was performed with a protocol outlined in the outside radiology report.In the right breast, there is a segmental non-mass enhancement at 12:00 position measuring 37 x 23 x 39 mm (AP x LR x CC). The maximum diagonal measurement on the sagittal plane of the lesion is 54 mm. A marker clip artifact is present at the anterior superior aspect of the lesion.No abnormal enhancement is seen in left breast. No abnormal lymph nodes are identified in either axillary region.
1. Biopsy proven right breast cancer. Breast MRI demonstrated extensive enhancement. Pathology slide should be reviewed at University of Chicago.2. No mammographic or MRI evidence of malignancy in the left breast.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.