74 year old female status post right lumpectomy in July 2014 for DCIS and ADH and left lumpectomy for invasive ductal carcinoma and DCIS in 2011. Patient has undergone radiation and hormonal therapy with tamoxifen. Patient presents today with focal tenderness and swelling of the left breast in the periareolar and retroareolar region and in an arc extending from the 11:00 radian laterally to the 3:00 radian. The patient also reports left axillary swelling. The patient had a recent mammogram on 5/13/2015 was benign. A targeted left ultrasound was performed for the patient’s areas of concern. Ultrasound of the entire left breast was performed, with special attention to the periareolar and retroareolar regions from 11:00 to 3:00. Patient reported moderate focal tenderness when the transducer was passed over those locations. Ultrasound of the left axilla was also performed. There is no solid or cystic mass identified. No abnormal-appearing left axillary lymph nodes.
No sonographic evidence for malignancy. No sonographic abnormality to explain the patient's symptoms for the swelling. Continued clinical management recommended. Further evaluation, including biopsy, of a clinically suspicious abnormality should not be delayed by negative imaging. Rather, negative imaging may serve to reinforce a negative clinical impression. The results were discussed with the patient at the completion of the exam, and the patient understood to follow-up with her physician.BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed.