A patient submitted outside study for review. Submitted for review are ultrasound images of left breast (10/26/2016), images from ultrasound guided biopsy of the left breast (11/3/2016), breast MRI (11/9/2016) performed at outside institution. Those studies are compared to the mammogram and ultrasound performed at University of Chicago on 11/10/2016. ULTRASOUND IMAGES OF LEFT BREAST (10/26/2016):An irregularly shaped hypoechoic mass measuring 13 x 11 mm is present at 5:00 position in the left breast. This is the same lesion located at 5:30 position in the left breast at the ultrasound study performed on 11/10/2016 at University of Chicago.IMAGES FROM ULTRASOUND GUIDED BIOPSY OF THE LEFT BREAST (11/3/2016):A needle biopsy of the left breast mass was performed with an appropriate needle placement. A marker clip is placed within the mass. The pathology result was malignant.BREAST MRI (11/9/2016):The study was performed with a protocol outlined in the outside radiology report.There is heterogeneous amount of fibroglandular tissue in both breasts.Marked parenchymal enhancement is noted bilaterally.A known cancer with a marker clip is demonstrated at posterior 5:00 position measuring 18 x 15 x 17 mm (AP x LR x CC). There is possible satellite lesion measuring 6 mm, located anterior to the main lesion. Total measurement including the main mass with possible satellite is 26 mm in AP dimension. This possible satellite is not the same one as seen at the ultrasound study on 11/10/2016 at University of Chicago. The satellite lesion seen on that ultrasound study is seen as a small focus attached to the lateral portion of the main mass on MRI.No other abnormal findings are seen elsewhere in the left breast or in the right breast.No abnormal lymph nodes are identified in either axillary region.
Known left breast cancer with possible anterior satellite. MR-directed ultrasound for the possible satellite lesion is recommended. If no lesion is found on ultrasound study, MR guided biopsy should be considered.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: E - Additional Mammo/Ultrasound Workup Required.