87 year old female with left breast invasive lobular carcinoma (two sites), on neoadjuvant Arimidex. Evaluate response to treatment. No family history of breast cancer. MAMMOGRAM: Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. There is decreased asymmetry in the left upper outer breast, adjacent to the coil-shaped clip. There is redemonstration of a winged shaped clip within the left retroareolar region. There has been no significant mammographic change within the left retroareolar region.ULTRASOUND: A targeted left ultrasound was performed. At the 2:00 position of the left breast, 5 cm from the nipple, there is redemonstration of the irregular hypoechoic mass today measuring 0.6 x 0.6 x 0.9 cm (previously 1.3 x 0.8 x 1.2 cm), with adjacent Hydromark clip.Within the left retroareolar region, there is redemonstration of a heterogeneous, hypoechoic lobulated mass today measuring 2.7 x 1.2 x 2.2 cm (previously 4.3 x 2.0 x 3.4 cm). Increased peripheral vascularity is present surrounding this mass.
Interval decrease in size of biopsy proven breast carcinomas within the retroareolar and two o'clock positions of the left breast.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.