Ms. Elaine Harris is a 75 year-old female with a personal history of right breast mass for 2 year duration. MAMMOGRAM:Three standard views and 2 spot compression views of both breasts as well as one exaggerated CC view of the right breast 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).There is a large, circumscribed dense mass in the upper outer right breast, posterior depth, measuring 5.4 x 6.4 cm. Two focal asymmetries in the upper outer left breast do not persist with spot compression. A right axillary lymph node is partially visualized.ULTRASOUND:On physical examination, a large mass is palpated in the right upper outer breast.A targeted right ultrasound was performed for the palpable and mammographic area of concern. In the right breast, 10:00 position, 8 cm from the nipple, there is a large complex cystic and solid mass measuring 4.5 x 3.4 cm. The solid component of this complex mass demonstrates increased blood flow and measures 1.2 x 3.4 cm, which could be the target for ultrasound-guided biopsy. Debris is also layering in this complex mass. Normal appearing lymph nodes are noted in the right axilla.
A large dense complex cystic and solid mass in the right breast 10:00 position measuring up to 6.4 cm mammographically. Ultrasound-guided biopsy of the solid component is recommended. Patient is on aspirin and she is advised that it will be optimal to withhold her aspirin for 5 days before biopsy, as long as it is reasonable for her primary physician who prescribed the medicine.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration.