Ms. ARLYNE MARKS is a 86 years old female with a personal history of status post left mastectomy in 1987 and right breast benign biopsy in 1999. She currently has no breast related complaints. MAMMOGRAM: Three standard views of the right breast as well as spot magnification views and additional MLO view were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses(BiRads Density Category C), unchanged in pattern and distribution.There are new loosely grouped calcifications in the upper outer right breast, which measure up to 2 cm in extent, with arterial calcifications noted within the vicinity. Note is made of an associated focal asymmetry/density on the spot magnification ML view which was further evaluated with ultrasound to look for invasive component.A scar marker overlies the right breast, indicating location of prior benign biopsy. There is a stable focal asymmetry in the lower right breast. A low-lying right axillary lymph node is unchanged. ULTRASOUND:A targeted right ultrasound was performed for the mammographic area of concern in the upper outer quadrant. There is no solid or cystic mass identified in the region of asymmetry/density seen on the spot magnification view.
New grouped calcifications in the upper outer left breast. The possibility of stereotactic biopsy was discussed; however, the patient was unable to tolerate the prone position, due to pain. Therefore, a referral was made to Weiss Hospital for an upright stereotactic biopsy. These findings were relayed to Dr. Avit Kapur from Weiss Hospital via telephone at the time of consultation. BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration.