A patient submitted outside study for review. Submitted for review are digital mammographic images (1/14/2016), ultrasound images of left breast (1/14/2016), images from ultrasound guided biopsy of left breast with postprocedural left mammographic images (1/18/2016), images from ultrasound-guided wire localization of left breast and left digital mammographic images with specimen radiographs (1/22/2016) performed at Centegra Hospital. DIGITAL MAMMOGRAPHIC IMAGES (1/14/2016):Submitted images are low quality and cannot be used for diagnostic images.ULTRASOUND IMAGES OF LEFT BREAST (1/14/2016):There is an irregularly shaped hypoechoic mass measuring approximately 3.5 x 1.7 cm at 6:00 position in the left breast. There is an additional irregularly-shaped masses at 6:00 position, measuring 10 x 10 mm. Per outside radiology report, the smaller mass locates anteriorly to the larger mass.IMAGES FROM ULTRASOUND GUIDED BIOPSY OF LEFT BREAST WITH POSTPROCEDURAL LEFT MAMMOGRAPHIC IMAGES (1/18/2016):Ultrasound guided biopsy was performed for the two 6:00 masses in the left breast and an additional irregularly shaped mass, measuring 15 x 7 mm, which is located at 5:00 position in the left breast. A biopsy needle appears to reach three masses.Per Epic note, those three biopsy results were all malignant.IMAGES FROM ULTRASOUND-GUIDED WIRE LOCALIZATION OF LEFT BREAST AND LEFT DIGITAL MAMMOGRAPHIC IMAGES WITH SPECIMEN RADIOGRAPHS (1/22/2016):Wire localization was performed under ultrasound guidance for the larger mass at 6 o'clock position in the left breast and mammographic guidance for other two masses in the left breast. Because of poor quality, post-procedural mammogram cannot be interpreted. Several radiographic images of specimen are also submitted, but they are also poor in quality.Per Epic note, surgical margins are free of tumor.
Status post wire localization and lumpectomy for left breast cancer. If available, good quality mammogram should be submitted. Alternatively, right unilateral mammogram is recommended for annual survey.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.