Ms. Andrews is a 32-year-old female with history of right breast cancer. Right axillary ultrasound requested for fullness in the right axilla. On physical examination, no palpable mass was identified.A targeted right axillary ultrasound was performed for the palpable area of concern. Two abnormal morphology lymph nodes were identified in the right axilla, labeled #1 and #2 on the ultrasound images with the following measurements: -Lymph node #1: Measures 1.6 cm x 0.9 cm x 0.9 cm and demonstrates cortical thickening and lobular contour. Minimal hilar flow is present on Doppler imaging. -Lymph node #2: Measures 1.7 cm x 0.6 cm x 2.6 cm and demonstrates cortical thickening and lobular contour. Minimal hilar flow is present on Doppler imaging.
Two abnormal morphology lymph nodes in the right axilla, which in setting of known breast cancer are suspicious for metastatic disease. Ultrasound-guided biopsy is recommended for the larger lymph node (labeled #2 above). Plan is to perform the ultrasound-guided biopsy later today. Findings discussed with the patient.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration.