49-year-old female patient with newly diagnosed invasive ductal carcinoma of the left breast. Patient has a history of right breast fibroadenoma in 1992. Patient palpated two masses in the L breast in 5/2015. DIAGNOSTIC MAMMOGRAM AND ULTRASOUND
1. Index cancer in the left breast breast 12:00 position measures up to 2.5 cm.2. Satellite mass that underwent biopsy in the upper outer quadrant of the left breast also compatible with malignancy. Note that the clip from this biopsy does not correspond to the additional area of microcalcifications on mammography. 3. Additional findings in the left breast suspicious for malignancy include: -Clustered pleomorphic calcifications seen on mammogram that likely correspond to the 6 x 9 mm enhancing mass in the left breast 12:00 position on MRI. -5 x 4 mm enhancing nodule in the left breast near the 8-o'clock position. -Further work up with targeted ultrasound and biopsies (12:00: US versus stereotactic biopsy; 8:00 US versus MRI biopsy) should be considered if it would change the surgical plan. 4. 7 x 5 mm focus of enhancement along the superior lateral left breast with skin hyperenhancement, may represent postbiopsy changes. Correlation with physical exam findings is recommended.5. No areas of abnormal enhancement in the right breast or bilateral axilla.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.