Ms. Frekko is a 42 y/o woman with recent diagnosis of grade 2 DCIS in the left breast, status post wire localized excision with close margins DCIS present <1mm from the inked margin at Rush Hospital. The following studies from outside facility are submitted for review.1. Bilateral diagnostic mammogram, 4/23/20152. MRI of both breasts, 5/13/2015, which was reviewed separately.3. Ultrasound of the left breast, 5/18/2015.4. Post procedure mammogram of the left breast, 5/18/20155. Needle localization on the left and radiograph of the left lumpectomy specimen 7/28/2015For comparison, MRI of breast 4/4/2011 is available BILATERAL DIAGNOSTIC MAMMOGRAM, 4/23/20152 standard views of the both breasts were performed. The breast parenchyma is heterogeneously dense. The left breast is larger than the right breast. There is a small asymmetry is present in the central left breast, posterior depth, only seen on the CC view that persists with compression.ULTRASOUND OF THE LEFT BREAST, 5/18/2015MRI directed ultrasound was performed over the central left breast based on the recent MRI finding (separately dictated). In the left breast, 1:00 location, 6 cm from the nipple, there is a 3-4 mm circumscribed hypoechoic area that is probably benign in appearance. Incidental note are made of a few small cysts in the left breast, 1-2 o'clock location.POSTPROCEDURE MAMMOGRAM OF THE LEFT BREAST, 5/18/2015A stereotactic biopsy was performed as per clinic note. However, no imaging of the biopsy is provided.CC and MLO views of the left breast demonstrated a biopsy clip in the upper, central left breast, which correlates in location with the nonmass enhancement on the MRI breast dated 5/13/2015.NEEDLE LOCALIZATION AND RADIOGRAPH OF THE LEFT LUMPECTOMY SPECIMEN 7/28/2015Left breast mammograms show successful wire placement adjacent to the biopsy clip. The biopsy clip and the adjacent focal asymmetry are present in the specimen radiograph.
Status post excision of the left breast clip from stereotactic biopsy. Correlation with surgical pathology is recommended.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.