A patient submitted outside study for review. Submitted for review are standard diagnostic mammogram (2/15/2016), bilateral breast ultrasound (2/15/2016), bilateral ultrasound-guided breast biopsy images (2/24/2016), and bilateral post-procedure mammogram (2/24/2016). These studies were performed at St. Anthony Breast Care Center in Crown Point, Indiana. Final pathology was benign for both breasts (PASH) as per Donna Christian, NP. Bilateral Diagnostic Mammogram (2/15/2016): Right CC view has been submitted only. The breast parenchyma is heterogeneously dense, which limits the sensitivity of the mammogram. Limited examination, please submit the remaining views.Bilateral Breast Ultrasound (2/15/2016): Targeted left breast ultrasound demonstrates a hypoechoic parallel mass with scattered cystic areas and some internal vascularity at the 12:00 position, approximately 4 cm from the nipple. The mass measures 4.9 x 1.1 x 5.4 cm and likely represents a fibroadenoma with cystic changes. Normal morphology lymph node is present in the left axilla.Targeted right breast ultrasound demonstrates a hypoechoic solid mass with cystic component and some internal vascularity at the 11:00 position, approximately 3 cm from the nipple. This mass measures 3.8 x 2.6 x 1.3 cm. Normal morphology lymph nodes are noted in the right axilla.Bilateral Ultrasound-Guided Breast Biopsy (2/24/2016): Core needle biopsy of the hypoechoic mass in the left breast, 12:00 position, is demonstrated with good targeting using a 14-gauge needle. 5 core specimens were obtained and a bowtie biopsy clip was placed.Core needle biopsy of the hypoechoic mass in the right breast, 11:00 position, is demonstrated with good targeting using a 14-gauge needle. 5 core specimens were obtained and a bowtie biopsy clip was placed.Bilateral Post-Procedure Mammogram (2/24/2016): CC and ML views of both breasts demonstrate heterogeneously dense parenchyma, which limits the sensitivity of the mammogram. Bowtie biopsy clips are noted in the upper outer quadrants of both breasts. No definite hematoma is identified in either breast.
Successful ultrasound-guided core needle biopsies of bilateral breast masses and clip placement. Final pathology was benign and concordant (PASH). Limited evaluation by mammography. Although the patient has heterogeneously dense breast, submission of left CC and bilateral MLO views is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: T - Take Appropriate Action - No Letter.