52-year-old female with right breast palpable lump for 1-2 months. The patient also has a history of congestive heart failure and sarcoidosis. Three standard views of both breasts with 3 spot compression views of right breast and 2 spot compression views of left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses (BiRads Density Category C), unchanged in pattern and distribution. An 18 mm focal asymmetry with irregular margins is present at the 2:00 position of the right breast which persists with spot compression. This corresponds to the palpable tiangular marker. A mole marker is placed over the sebaceous cyst in the left axilla. Spot compression of an oval enlarged right axillary lymph node was performed. Additional spot compression of an asymmetry in the left central breast mid depth disperses into benign-appearing glandular tissue. ULTRASOUND
Palpable right breast mass as described above is suspicious for neoplasm. Additionally an 8 mm lymph right axillary lymph node demonstrates cortical thickening which could represent malignancy or possibly sarcoidosis given the patient's clinical history. Ultrasound-guided biopsies of both the right breast mass and right axillary lymph node are recommended. This was discussed with the patient who agreed to participate in the Allan Penn research trial. Sharon Harris will contact the patient with further instructions. BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration.