45-year-old female recalled from screening mammography following identification of two new masses in the right breast, one at the 6:00 position, and the other at the 10:00 position. Six diagnostic mammograms of the right breast were performed including a standard ML view, spot compression MLO, ML and CC views as well as rolled medial and lateral CC views. Directed gray scale and color Doppler ultrasound was subsequently performed on the right breast.The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. The masses for which the patient was recalled appear as well-circumscribed oval masses at the 6:00 position and 10:00 position of the right breast. These are compatible with benign cysts as subsequently documented on ultrasound.Grayscale and color Doppler ultrasound identified two cysts as follows:1. A six o'clock periareolar 1.4 x 1.5 cm oval, circumscribed, anechoic cyst with posterior enhancement and no internal flow. This corresponds to the new mammographic finding. Incidentally, this cyst was seen on the prior MRI, and had completely benign features with no enhancement.2. A 10:00 periareolar 0.9 x 0.4 x 0.6 cm lobulated, circumscribed, anechoic cyst with posterior enhancement and no internal flow. The component lobulations measured 0.7 and 0.5 cm. These cysts correspond to the findings on the screening mammogram that triggered this exam.
Simple cysts at the 10:00 and 6:00 positions of the right breast explain the findings on the recent screening mammogram that triggered this exam. No further evaluation is necessary. There is no mammographic evidence for malignancy. As long as the patient's physical examination remains normal, annual bilateral screening mammography is recommended.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram.