33-year-old female with biopsy-proven right breast cancer, suspected second lesion on MRI and right breast non-mass enhancement. Second look ultrasound for further evaluation. Targeted ultrasound of the left lower inner breast demonstrates two adjacent hypoechoic masses with microcalcifications. These masses are 1 cm apart. The more lateral and inferior of these masses (right breast 4:00 7 cm from the nipple) measures 1.0 x 0.8 x 1.2 cm and contains a biopsy clip and is consistent with the biopsy-proven malignancy. The more superior and medial of these masses (right breast 4:00 position 6 cm from the nipple) measures 1.1 x 0.8 x 1.0 cm and correlates with the additional lesion seen on MRI. Multiple cysts are present in the right inferior breast as well, but there is no definite pathologic sonographic correlate for the non-mass enhancement seen on MRI.
1. Two adjacent masses in the lower inner right breast as described above, one correlating with the patient's biopsy-proven malignancy, the other correlating with the finding on recent MRI examination. This second mass is amenable to ultrasound-guided biopsy as warranted clinically.2. No definite sonographic correlate for the additional right breast non-mass enhancement seen on MRI. If breast conservation therapy is desired, MRI biopsy is recommended.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.