28-year-old female with biopsy proven right breast cancer with metastatic axillary lymphadenopathy currently on chemotherapy here for diagnostic mammogram to assess response. Family history of breast cancer in maternal great aunt. RIGHT BREAST DIAGNOSTIC MAMMOGRAM: Three standard views of the right 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. There is redemonstration of diffuse pleomorphic and linear branching calcifications which overall has decreased in size compared to prior study, currently measuring previously 12.5 cm x 10.2 cm previously 13.5 cm x 12.7 cm as measured on the MLO view. RIGHT BREAST ULTRASOUND:Physical exam demonstrated a firm mass in the upper outer quadrant of the right breast.A targeted right ultrasound was performed for the mammographic area of concern. In the upper outer quadrant of the right breast 10:00 position 5 cm from the nipple is an irregular heterogeneous mass with internal calcification measuring 2.8 cm x 1.0 cm x 2.7 cm, previously 4.3 cm x 2.9 cm x 4.0 cm; there is associated internal vascularity on Doppler evaluation.Two abnormal lymph nodes in the right axilla are again seen, one of which measures 0.8 cm x 0.5 cm x 0.7 cm, and the other measures 0.7 cm x 0.6 cm, with minimal associated internal vascularity. These are also decreased in size when compared to prior study, the largest of which measured 1.9 cm x 1.6 cm.
Decreasing size of right upper outer quadrant calcified breast mass and axillary lymph nodes. Consultation with the patient's physician is recommended for clinical correlation and to determine further management.BIRADS: 6 - Known cancer.RECOMMENDATION: C - Clinical Correlation Needed.