60 year old female who was recalled from screening mammogram for new focal asymmetry in the right upper central breast. Mammogram: An ML view and two spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density(BiRads Density Category B), unchanged in pattern and distribution. 13 mm focal asymmetry in the right breast 12:00 position persists on spot compression views. No associated calcifications noted. On spot compression views the asymmetry demonstrates irregular margins.Ultrasound: Ultrasound demonstrates hypoechoic mass at 12:00 position, with apical blood flow measuring 6 x 6 x 5 mm. A possible hyperechoic septation is noted within the mass. Differential includes a complicated cyst however given that no definite posterior acoustic enhancement is noted, presence of apical blood flow, and suspicious morphology on mammogram, ultrasound-guided core biopsy is recommended.
Screening detected mass right breast 12:00 position with sonographic correlate, ultrasound-guided core biopsy is recommended for further evaluation.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration.