59-year-old female with history of end-stage renal disease, multiple prior central venous access, and currently receiving dialysis via an upper arm graft on the left was recalled from her baseline screening mammogram for a small mass in the upper outer periareolar region of the right breast. No current breast related complaints. No prior breast biopsy seizure. No family history of breast cancer. An ML view and two spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 8.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. The asymmetry persists and has the appearance of a small mass at the periareolar 10:00 position of the right breast. Note is made of extensive distended venous collaterals in the right breast as well as arterial calcifications.Ultrasound: Targeted ultrasound performed the area of mammographic concern. There is a fairly circumscribed 0.6 x 0.3 x 0.4 cm hypoechoic mass with partially smooth curved margins and partially irregular angulated margins located at the 10:00 periareolar position of the right breast at mid depth. This corresponds in size, shape, and location to the asymmetry that triggered this exam. There is questionable marginal blood flow on color Doppler imaging.
Indeterminate mass at the 10:00 periareolar position of the right breast. Both benign and malignant etiologies are possible. Ultrasound-guided core biopsy recommended. The results and recommendations were discussed with the patient at the completion of the exam, and the patient elected to undergo the biopsy. She was instructed that our Department will contact her to arrange an appointment for the biopsy.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneus Biopsy/Aspiration.