Ms. Johnson is a 51 year old female with a recent diagnosis of metastatic adenocarcinoma of the left axillary lymph node, concerning for breast primary. She presents today for further evaluation to locate the breast primary. Given patient's body habitus and limited mobility, a breast mammogram was not able to be performed today. Therefore, a whole left breast ultrasound was performed.In the left breast 2:00 location, approximately 10 cm from the nipple, there is an irregular hypoechoic mass identified measuring 1.5 x 0.7 x 0.9 cm. There is moderate associated vascularity.This mass is located approximately 3.3 cm inferolateral to the recently biopsied left axillary lymph node.
1.5 cm suspicious mass in the left upper outer breast, likely representing patient's breast primary. An ultrasound-guided biopsy with clip placement can be attempted if clinically warranted. All results and recommendations were discussed with the patient.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: T - Take Appropriate Action - No Letter.