52-year-old female called back from screening mammography for further evaluation of cluster of calcifications in the upper outer right breast. DIAGNOSTIC RIGHT BREAST MAMMOGRAM: Right ML, 2 right breast magnified, and 2 right breast spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. There is cluster of calcifications in the right upper outer quadrant which layer anteriorly and posteriorly. Centrally the calcifications are not layering however is stable from prior study. Additionally a small cluster of calcifications in the upper outer quadrant quadrant at the posterior depth is noted overlying the stable intramammary lymph nodes. Scattered calcifications elsewhere are also present. All of these calcifications are mostly unchanged compared to the 2012 examination.Additionally, there is focal lesion at the 12:00 position which disperses into normal breast parenchyma on spot compression.RIGHT BREAST ULTRASOUND: A targeted right breast ultrasound was performed. There are multiple calcifications as well as small cysts with the largest measuring up to 6 x 3 mm from the 9 to 10:00 position; findings consistent with fibrocystic changes. Additionally, there are at least 2 benign-appearing lymph nodes at the 11:00 position, 4 cm from the nipple measuring up to 10 x 5 mm. No sonographic evidence of a solid or cystic mass at the 12:00 position.
Findings consistent with fibrocystic changes in the right upper outer quadrant. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually given history of calcifications. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.