As per discussion of the interdisciplinary conference, patient presents for right axillary ultrasound. History of right lumpectomy for breast cancer in 2013, now with new biopsy-proven cancer in the right central breast. A targeted right axillary ultrasound was performed. Patient has a history of prior sentinel lymph node biopsy. A bilobed hypoechoic lesion in the right lower axilla measures 8 x 4 x 4 mm with minimal to no blood flow. This could represent an abnormal lymph node. Another smaller lymph node measures 4 x 2 x 4 mm. A large lymph node with fatty hilum is identified in the right higher axilla that measures 12 x 7 mm.
Two suspicious subcentimeter lymph nodes in the right axilla one of them amenable to ultrasound-guided biopsy. Patient is on Coumadin. Findings discussed with Dr. Barrera and Donna Christian at the time of dictation.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.