Ms. Cope is a 66-year-old female who presents for six-month follow-up for focal asymmetry in the right upper inner breast. Three standard views of the right breast and additional right spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density (BiRads Density Category B), unchanged in pattern and distribution. The focal asymmetry in the right upper inner breast at posterior depth is again seen, questionably increased on ML spot view. Targeted right breast ultrasound was subsequently performed.ULTRASOUND
Focal asymmetry in the right breast at the 2:00 position with a low suspicion correlate hypoechoic lesion on ultrasound, for which ultrasound-guided biopsy is recommended. If a clear ultrasound correlate is not readily identified at the time of biopsy (or if clip placement does not correlate with the mammographic finding), stereotactic biopsy could be undertaken. Results and recommendations were discussed with the patient.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration.