55 year old female who was recalled from screening mammogram for right outer breast focal asymmetry. Personal history of bilateral benign breast biopsies. Family history of breast cancer in mother. 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, unchanged in pattern and distribution. 6-mm, round mass in the right lower/central with possible correlate in the central right breast posterior depth is noted. A 5-mm oval, partially circumscribed mass in the right upper, outer quadrant posterior depth is also noted that persists on spot compression views which could represent a benign intramammary lymph node. Ultrasound was subsequently performed.Ultrasound:Targeted left breast ultrasound is performed. A possible septated cyst identified in the right breast 8 o'clock position measuring 6 x 4 mm, corresponding to the new mammographic abnormality in question. No apical or peripheral blood flow is noted. In the right upper, outer quadrant a 6 x 4 mm benign intramammary lymph node with central fatty hilum is identified, possibly corresponding to the mammographic stable focal asymmetry in the upper outer quadrant.
6-mm new mass, right breast 8 o'clock position, with sonographic correlate, most likely representing a septated cyst. Options of a 6 month follow-up versus ultrasound guided cyst aspiration were discussed with the patient. Ultrasound guided cyst aspiration and post procedure mammogram to document resolution is planned.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration.