65-year-old female with known right breast cancer, with a satellite lesion detected on outside MRI. Ultrasound study is requested to look for the satellite lesion. Focused ultrasound is performed for the right lower outer breast. The index lesion, measuring 7 x 7 mm, is again detected at 7:00 position, 5 cm from the nipple. Immediate anterior and superior to the index lesion, there is a hypoechoic lesion measuring 5 x 4 mm with increased blood flow, consistent with a satellite lesion. The total measurement of index lesion with satellite lesion is approximately 1.2 cm in AP dimension. AP distance of index plus satellite lesion on MRI is 1.8 cm, and the shorter ultrasound measurement is probably due to patient's supine position. A marker clip is detected at inferoanterior to the index lesion.
MR-directed ultrasound successfully detected anterior satellite in the right breast. Ultrasound-guided wire localization for index lesion and satellite lesion can be performed for breast conservation surgery.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.