A patient submitted outside study for review. Submitted for review are digital mammographic images (4/5/16, 4/28/16), post procedural bilateral digital mammographic images (5/3/16) performed at St. James Olympia Fields. For comparison, ultrasound images (4/28/16, 5/3/16) are available (dictated separately). DIGITAL MAMMOGRAPHIC IMAGES (4/5/16, 4/28/16):The breast parenchyma is composed of scattered fibroglandular elements (BiRADS Density Category B). There are 2 spiculated masses in the right breast at upper inner quadrant; anteriorly located mass measures 11 mm, and posteriorly located mass measures 19 mm. In the left breast, there is a spiculated mass at upper outer quadrant measuring 15 mm.Multiple benign appearing calcifications are seen in both breasts. 3 linear scar markers overlie left breast.POST PROCEDURAL BILATERAL DIGITAL MAMMOGRAPHIC IMAGES (5/3/16):Images are obtained after ultrasound-guided biopsy of the right breast (2 sites) and left breast (one site).A marker clip is placed approximately 1 cm lateral to the spiculated mass at anterior upper inner quadrant in the right breast. A marker clip is placed within the spiculated mass at posterior upper inner quadrant in the right breast and a spiculated mass at upper outer quadrant in the left breast. Per outside pathology report, all 3 lesions are malignant.
Known right and left breast cancer (2 sites in right breast, and one site in the left breast). Given multiple synchronous breast cancers, recommend bilateral breast MRI.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.