Ms. Larson is a 61-year-old woman with metastatic breast cancer. She presents today with clinician- and self-palpated left cervical nodes. The clinical team requests biopsy of one of these nodes for ER/PR/HER-2 receptor status to guide treatment planning. On physical exam, there are two palpable nodes in the left cervical region, superficial to the sternocleidomastoid muscle. No abnormality is palpated in the supraclavicular region.Targeted left cervical ultrasound was performed for the palpable and clinical areas of concern. There is no lymphadenopathy visualized by ultrasound in the supraclavicular region.The first and superior most palpable left cervical node corresponds to a 12 x 5 x 10 mm isoechoic node without increased vascular. The second and inferior most palpable cervical node corresponds to a 8 x 6 x 10 mm hypoechoic node without increased vascularity.
Left cervical lymphadenopathy. Ultrasound-guided core biopsy of the superior most node was performed during today's visit and will be reported under a separate accession.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration.