48-year-old with left breast invasive ductal carcinoma currently on neoadjuvant chemotherapy. No current complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Marked interval decrease in size of left upper outer quadrant mass corresponding to the site of the patient's previously biopsied known malignancy. A lock clip marks this location. There is small residual asymmetry medially in anterior to the clip better evaluated on today's MRI.No new masses, calcifications, or asymmetries in either breast.Small benign axillary lymph nodes bilaterally.  Targeted ultrasound of the left breast was then performed at the site of the patient's known malignancy. At the site of the previously identified lesion 8 cm from the nipple in the 2:00 radian there remains a irregularly marginated hypoechoic mass measuring 1.9 x 1.1 x 3.4 cm (previously 1.9 x 1.4 x 1.5 cm). Compared to prior, the appearance is less masslike. No significant internal vascularity is noted.
Marked interval decrease in size of the patient's known malignant left upper outer breast mass on mammogram. Altered configuration on ultrasound, where there appears to be a band like area than a focal mass. No new masses or new suspicious abnormalities in either breast.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.