55 year old female with multiple right breast masses and right axillary adenopathy who was recalled from interpretation of outside examination for left breast asymmetry. History of ovarian cancer in sister diagnosed at age 45. LEFT UNILATERAL DIGITAL DIAGNOSTIC MAMMOGRAM: A ML view and 3 spot compression views of the left breast 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. There is redemonstration of a 1 cm mass in the the medial central left breast, which persists on compression imaging.LEFT BREAST ULTRASOUND: A targeted left ultrasound was performed for the mammographic area of concern. At the 9 o'clock position of the left breast, 3 cm from the nipple, there is a benign morphology intramammary lymph node measuring 0.7 cm, with normal color flow, corresponding to the finding on mammogram. At the 3 o'clock position of the left breast, 4 cm from the nipple, there is a 0.4 x 0.4 x 0.2 cm hypoechoic mass with ill-defined margins.
Ill-defined hypoechoic 0.4 cm mass at the 3 o'clock position of the left breast. While this may represent benign lesion, fine-needle aspiration with possible ultrasound guided core needle biopsy is recommended for definitive histologic diagnosis. Results and recommendations were discussed with the patient.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration.