A patient submitted outside study for review. Submitted for review are digital mammographic images (8/24/16), images from stereotactic biopsy of right breast with specimen radiograph and postprocedural right mammographic images (9/16/2016), breast MRI (9/27/2016) performed at outside institution. DIGITAL MAMMOGRAPHIC IMAGES (8/24/16):The breast parenchyma is composed of scattered fibroglandular elements (BiRADS Density Category B). A cluster of pleomorphic calcifications is present at posterior lower outer quadrant in the right breast, measuring 13 x 10 mm.No dominant mass, suspicious microcalcifications or areas of architectural distortion are noted in left breast. IMAGES FROM STEREOTACTIC BIOPSY OF RIGHT BREAST WITH SPECIMEN RADIOGRAPH AND POSTPROCEDURAL RIGHT MAMMOGRAPHIC IMAGES (9/16/2016):Stereotactic biopsy of the right breast calcifications at lower outer quadrant was performed by lateral approach. Specimen radiograph demonstrates multiple target calcifications in at least 6 samples. Postprocedural right mammographic images show a marker clip is placed approximately 18 mm medially from the target.Per outside pathology report, the result was malignant; invasive ductal carcinoma grade 3 with ductal carcinoma in situ grade 2 and 3.BREAST MRI (9/27/2016):Breast MRI was performed with a protocol outlined in the outside report. There is a linear non-mass enhancement corresponding to the biopsy-proven carcinoma at posterior lower outer quadrant in the right breast measuring 19 x 18 x 22 mm (AP x LR x CC). A marker clip is present at medial aspect of this non-mass enhancement. There is a linear enhancement from this lesion to lateral side of the skin, consistent with biopsy changes. Multiple slowly enhancing foci and masses are seen in the left breast, likely parenchymal enhancement and benign lesions. No abnormal lymph nodes are identified in either axillary region.
Biopsy proven invasive and in situ carcinoma at posterior lower outer quadrant in the right breast. Although a marker clip is displaced medially on mammogram, MRI demonstrates a marker clip is located within the enhancing lesion.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.