Ms.Tara Schlitz, 32 years old, submitted outside study for review. She initially presented to outside facility for a palpable concern in the left breast.Images performed at Advocate Christ Medical Center submitted for review: Diagnostic ultrasound of both breasts 12/8/2015Ultrasound-guided biopsy of left breast 12/17/2015Postprocedure mammogram 2/17/2015MRI breast 12/24/2015Images submitted for comparison:None Mammogram 12/8/2015: As per other side report, bilateral diagnostic mammogram was performed but not submitted for review at the time of this dictation.Both Breast Ultrasound 12/8/2015 : Static ultrasound images are submitted for interpretation.Left breast:In the left breast, 1:00 position, 6 cm from the nipple, at the site labeled as palpable area, there is a 1.9 x 1.3 x 1 cm hypoechoic, oval mass with internal and peripheral flow. In addition, 2 normal-appearing lymph nodes are noted in the left axilla.Right breast:Normal breast tissue is noted on the images labeled as right breast 12:00, 3:00, 6:00, 9:00 and 12:00 retroareolar region. No suspicious lymph node is noted on the image labeled as right breast axilla.Ultrasound-Guided Biopsy Of The Left Breast Breast 12/17/2015: Previously identified mass in the left breast 1:00 position was the target for the biopsy. Targeting appeared appropriate.Left Unilateral Post Procedure Mammogram (10/19/2015): An approximately 11 mm mass is noted in the left upper outer breast, far posterior depth, in close proximity of the pectoralis muscle. A biopsy marking clip is seen approximately 3 mm slightly medial and inferior to the mass.MRI BREAST 12/24/2015:Multisequence and multiplanar MRI of both breasts with and without IV contrast were performed as outside MRI protocol.The breasts are composed of extreme breast tissue. There is minimal background parenchymal enhancement bilaterally. In the left breast, 1:00 position, 6 cm from the nipple, there is an enhancing mass measuring 17 x 14 x 16 mm (AP X LR X SI). A susceptibility artifact from the biopsy clip is noted in the medial and inferior aspect of this enhancing mass. This is compatible with the known history of biopsy-proven malignancy. The lesion abuts the pectoralis muscle without abnormal enhancement of the pectoralis muscle. Postbiopsy changes are noted in vicinity of this biopsy-proven cancer. No additional suspicious enhancement is noted in either breast. Visualized axillary lymph nodes are unremarkable.Per Outside Pathology:A. Left breast breast lesion, 1:00 position; ultrasound guided core needle biopsy:- Invasive ductal carcinoma, grade 3
1. Biopsy-proven 17 mm unifocal cancer in the posterior left breast without chest wall involvement.2. No abnormal finding in the right breast.3. Unremarkable axillary lymph nodes.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.