A patient submitted outside study for review. Submitted for review are images from stereotactic biopsy of right breast with specimen radiograph (1/14/15), ultrasound images of right breast including biopsy procedure (1/14/15), digital mammographic images of right breast (1/14/15), breast MRI (2/5/15), images from stereotactic biopsy of right breast with specimen radiograph and post-procedural digital mammographic images (2/18/15) performed at Midwest Center for Advanced Imaging. IMAGES FROM STEREOTACTIC BIOPSY OF RIGHT BREAST WITH SPECIMEN RADIOGRAPH (1/14/15):No prior standard mammographic images are provided.Stereotactic biopsy was performed for the right breast at 12:00 position, middle depth. A cluster of pleomorphic calcifications are confirmed with specimen radiograph. Per outside radiology report, the pathology result was malignant; DCIS.ULTRASOUND IMAGES OF RIGHT BREAST INCLUDING BIOPSY PROCEDURE (1/14/15):Ultrasound images of right subareolar region are obtained. There is a hypo-/anechoic mass measuring 5 x 3 mm at the right subareolar region. Ultrasound guided needle biopsy is performed for this hypo-/anechoic mass, and complete resolution of the mass is obtained after the biopsy. Per outside radiology report, the biopsy result was benign.DIGITAL MAMMOGRAPHIC IMAGES OF RIGHT BREAST (1/14/15):This study was done as a post-procedural imaging. Two marker clips are identified in the right breast, one at 12:00 position, middle depth, at the site of proven DCIS, and the other at the retroareolar region for the benign ultrasound-guided biopsy. Amorphus calcifications are seen anterior to the marker clip of the DCIS site, extending approximately 13 mm. A cluster of coarse calcifications is seen at the central aspect in the right breast.BREAST MRI (2/5/15):Breast MRI was performed with a protocol outline in the outside radiology report. There is a linear non-mass enhancement at 12:00 position, middle to anterior measuring 19 x 10 x 8 mm (AP x LR x CC) in the right breast, corresponding to the biopsy-proven DCIS. The marker clip is present at the posterior aspect of this linear enhancement. There is a focal non-mass enhancement measuring 18 x 10 x 11 mm at the central aspect of the right breast.No abnormal enhancement is seen in left breast. No abnormal lymph nodes are identified in either axillary region.IMAGES FROM STEREOTACTIC BIOPSY OF RIGHT BREAST WITH SPECIMEN RADIOGRAPH AND POST-PROCEDURAL DIGITAL MAMMOGRAPHIC IMAGES (2/18/15):Stereotactic biopsy was performed for the cluster of calcifications seen in the central aspect of the right breast. Specimen radiographs show multiple coarse calcifications within the specimens. Postprocedural right mammographic images show the marker clip at the central aspect in the right breast, corresponding to the area of focal non-mass enhancement seen on the MRI. Per outside radiology report, the pathology result was benign; sclerosing intraductal papilloma without atypia. The pathology result is concordant with imaging findings.
1. Biopsy-proven DCIS in the right breast at 12:00 position. 2. MR detected focal non-mass enhancement at central right breast, correlating to a cluster of coarse calcifications on mammogram, and the stereotactic biopsy of these calcifications revealed benign papilloma. If breast conservation surgery is performed for the right breast DCIS, follow-up MRI is recommended in 6 months.3. No MR evidence for malignancy in the left breast.4. No abnormal lymph nodes in either axillary region.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.